Infective endocarditis after transcatheter aortic valve implantation: results from a large multicenter registry

Ignacio J Amat-Santos¹, David Messika-Zeitoun¹, Helene Eltchaninoff¹, Samir Kapadia¹, Stamatios Lerakis¹, Asim N Cheema¹, Enrique Gutiérrez-Ibanes¹, Antonio J Munoz-Garcia¹, Manuel Pan¹, John G Webb¹, Howard C Herrmann¹, Susheel Kodali¹, Luis Nombela-Franco¹, Corrado Tamburino¹, Hasan Jilaihawi¹, Jean-Bernard Masson¹, Fabio Sandoli de Brito Jr¹, Maria Cristina Ferreira¹, Valter Correa Lima¹, José Armando Mangione¹, Bernard Iung¹, Alec Vahanian¹, Eric Durand¹, E Murat Tuzcu¹, Salim S Hayek¹, Rocio Angulo-Llanos¹, Juan J Gómez-Doblas¹, Juan Carlos Castillo¹, Danny Dvir¹, Martin B Leon¹, Eulogio Garcia¹, Javier Cobiella¹, Isidre Vilacosta¹, Marco Barbanti¹, Raj R Makkar¹, Henrique Barbosa Ribeiro¹, Marina Urena¹, Eric Dumont¹, Philippe Pibarot¹, Javier Lopez¹, Alberto San Roman¹, Josep Rodés-Cabau²

Affiliations

¹ From Quebec Heart & Lung Institute, Quebec, Canada (I.J.A.-S., H.B.R., M.U., E.D., P.P., J.R.-C.); Hospital Clínico Universitario de Valladolid, Spain (I.J.A.-S., J.L, A.S.R.); Assistance Publique-Hôpitaux de Paris, Bichat Hospital, France (D.M.-Z., B.I., A.V.); Hôpital Charles Nicolle, University of Rouen, France (H.E., E.D.); Department of Cardiovascular Medicine, Cleveland Clinic, OH (S. Kapadia, E.M.T.); Emory University School of Medicine, Division of Cardiology, Atlanta, GA (S.L., S.S.H.); St. Michael's Hospital Toronto, ON, Canada (A.C.); Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain (E.G.-I., R.A.-L.); Hospital Universitario Virgen de la Victoria, Málaga, Spain (A.M.-G., J.J.G.-D.); Hospital Universitario Reina Sofía, Córdoba, Spain (M.P., J.C.C.); St. Paul's Hospital, Vancouver, BC, Canada (J.G.W., D.D.); Hospital of the University of Pennsylvania, Philadelphia (H.H.); Columbia University Medical Center/New York Presbyterian Hospital, NY (S. Kodali, M.B.L.); Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain (L.N.-F., E.G., J.C., I.V.); Ferrarotto Hospital, University of Catania, Italy (C.T., M.B.); Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (H.J., R.M.); Centre Hospitalier de l'Université de Montréal, QC, Canada (J.-B.M.); Hospital Israelita Albert Einstein, Sao Paulo, Brazil (F.S.d.B.); Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil (M.C.F.); Hospital Sao Francisco-Santa Casa de Misericórdia, Porto Alegre, Porto Alegre, Brazil (V.C.L.); and Hospital Beneficência Portuguesa, Sao Paulo, Brazil (J.A.M.).
² From Quebec Heart & Lung Institute, Quebec, Canada (I.J.A.-S., H.B.R., M.U., E.D., P.P., J.R.-C.); Hospital Clínico Universitario de Valladolid, Spain (I.J.A.-S., J.L, A.S.R.); Assistance Publique-Hôpitaux de Paris, Bichat Hospital, France (D.M.-Z., B.I., A.V.); Hôpital Charles Nicolle, University of Rouen, France (H.E., E.D.); Department of Cardiovascular Medicine, Cleveland Clinic, OH (S. Kapadia, E.M.T.); Emory University School of Medicine, Division of Cardiology, Atlanta, GA (S.L., S.S.H.); St. Michael's Hospital Toronto, ON, Canada (A.C.); Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain (E.G.-I., R.A.-L.); Hospital Universitario Virgen de la Victoria, Málaga, Spain (A.M.-G., J.J.G.-D.); Hospital Universitario Reina Sofía, Córdoba, Spain (M.P., J.C.C.); St. Paul's Hospital, Vancouver, BC, Canada (J.G.W., D.D.); Hospital of the University of Pennsylvania, Philadelphia (H.H.); Columbia University Medical Center/New York Presbyterian Hospital, NY (S. Kodali, M.B.L.); Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain (L.N.-F., E.G., J.C., I.V.); Ferrarotto Hospital, University of Catania, Italy (C.T., M.B.); Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (H.J., R.M.); Centre Hospitalier de l'Université de Montréal, QC, Canada (J.-B.M.); Hospital Israelita Albert Einstein, Sao Paulo, Brazil (F.S.d.B.); Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil (M.C.F.); Hospital Sao Francisco-Santa Casa de Misericórdia, Porto Alegre, Porto Alegre, Brazil (V.C.L.); and Hospital Beneficência Portuguesa, Sao Paulo, Brazil (J.A.M.). josep.rodes@criucpq.ulaval.ca.

PMID: 25753535
DOI: 10.1161/CIRCULATIONAHA.114.014089

Infective endocarditis after transcatheter aortic valve implantation: results from a large multicenter registry

Ignacio J Amat-Santos et al. Circulation. 2015.

. 2015 May 5;131(18):1566-74.

doi: 10.1161/CIRCULATIONAHA.114.014089. Epub 2015 Mar 9.

Authors

Affiliations

¹ From Quebec Heart & Lung Institute, Quebec, Canada (I.J.A.-S., H.B.R., M.U., E.D., P.P., J.R.-C.); Hospital Clínico Universitario de Valladolid, Spain (I.J.A.-S., J.L, A.S.R.); Assistance Publique-Hôpitaux de Paris, Bichat Hospital, France (D.M.-Z., B.I., A.V.); Hôpital Charles Nicolle, University of Rouen, France (H.E., E.D.); Department of Cardiovascular Medicine, Cleveland Clinic, OH (S. Kapadia, E.M.T.); Emory University School of Medicine, Division of Cardiology, Atlanta, GA (S.L., S.S.H.); St. Michael's Hospital Toronto, ON, Canada (A.C.); Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain (E.G.-I., R.A.-L.); Hospital Universitario Virgen de la Victoria, Málaga, Spain (A.M.-G., J.J.G.-D.); Hospital Universitario Reina Sofía, Córdoba, Spain (M.P., J.C.C.); St. Paul's Hospital, Vancouver, BC, Canada (J.G.W., D.D.); Hospital of the University of Pennsylvania, Philadelphia (H.H.); Columbia University Medical Center/New York Presbyterian Hospital, NY (S. Kodali, M.B.L.); Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain (L.N.-F., E.G., J.C., I.V.); Ferrarotto Hospital, University of Catania, Italy (C.T., M.B.); Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (H.J., R.M.); Centre Hospitalier de l'Université de Montréal, QC, Canada (J.-B.M.); Hospital Israelita Albert Einstein, Sao Paulo, Brazil (F.S.d.B.); Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil (M.C.F.); Hospital Sao Francisco-Santa Casa de Misericórdia, Porto Alegre, Porto Alegre, Brazil (V.C.L.); and Hospital Beneficência Portuguesa, Sao Paulo, Brazil (J.A.M.).
² From Quebec Heart & Lung Institute, Quebec, Canada (I.J.A.-S., H.B.R., M.U., E.D., P.P., J.R.-C.); Hospital Clínico Universitario de Valladolid, Spain (I.J.A.-S., J.L, A.S.R.); Assistance Publique-Hôpitaux de Paris, Bichat Hospital, France (D.M.-Z., B.I., A.V.); Hôpital Charles Nicolle, University of Rouen, France (H.E., E.D.); Department of Cardiovascular Medicine, Cleveland Clinic, OH (S. Kapadia, E.M.T.); Emory University School of Medicine, Division of Cardiology, Atlanta, GA (S.L., S.S.H.); St. Michael's Hospital Toronto, ON, Canada (A.C.); Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain (E.G.-I., R.A.-L.); Hospital Universitario Virgen de la Victoria, Málaga, Spain (A.M.-G., J.J.G.-D.); Hospital Universitario Reina Sofía, Córdoba, Spain (M.P., J.C.C.); St. Paul's Hospital, Vancouver, BC, Canada (J.G.W., D.D.); Hospital of the University of Pennsylvania, Philadelphia (H.H.); Columbia University Medical Center/New York Presbyterian Hospital, NY (S. Kodali, M.B.L.); Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain (L.N.-F., E.G., J.C., I.V.); Ferrarotto Hospital, University of Catania, Italy (C.T., M.B.); Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (H.J., R.M.); Centre Hospitalier de l'Université de Montréal, QC, Canada (J.-B.M.); Hospital Israelita Albert Einstein, Sao Paulo, Brazil (F.S.d.B.); Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil (M.C.F.); Hospital Sao Francisco-Santa Casa de Misericórdia, Porto Alegre, Porto Alegre, Brazil (V.C.L.); and Hospital Beneficência Portuguesa, Sao Paulo, Brazil (J.A.M.). josep.rodes@criucpq.ulaval.ca.

PMID: 25753535
DOI: 10.1161/CIRCULATIONAHA.114.014089

Erratum in

Correction to: Infective Endocarditis After Transcatheter Aortic Valve Implantation: Results From a Large Multicenter Registry.
[No authors listed] [No authors listed] Circulation. 2020 Jun 2;141(22):e879. doi: 10.1161/CIR.0000000000000819. Epub 2020 Jun 1. Circulation. 2020. PMID: 32479197 No abstract available.

Abstract

Background: We aimed to determine the incidence, predictors, clinical characteristics, management, and outcomes of infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI).

Methods and results: This multicenter registry included 53 patients (mean age, 79±8 years; men, 57%) who suffered IE after TAVI of 7944 patients after a mean follow-up of 1.1±1.2 years (incidence, 0.67%, 0.50% within the first year after TAVI). Mean time from TAVI was 6 months (interquartile range, 1-14 months). Orotracheal intubation (hazard ratio, 3.87; 95% confidence interval, 1.55-9.64; P=0.004) and the self-expandable CoreValve system (hazard ratio, 3.12; 95% confidence interval, 1.37-7.14; P=0.007) were associated with IE (multivariate analysis including 3067 patients with individual data). The most frequent causal microorganisms were coagulase-negative staphylococci (24%), followed by Staphylococcus aureus (21%) and enterococci (21%). Vegetations were present in 77% of patients (transcatheter valve leaflets, 39%; stent frame, 17%; mitral valve, 21%). At least 1 complication of IE occurred in 87% of patients (heart failure in 68%). However, only 11% of patients underwent valve intervention (valve explantation and valve-in-valve procedure in 4 and 2 patients, respectively). The mortality rate in hospital was 47.2% and increased to 66% at the 1-year follow-up. IE complications such as heart failure (P=0.037) and septic shock (P=0.002) were associated with increased in-hospital mortality.

Conclusions: The incidence of IE at 1 year after TAVI was 0.50%, and the risk increased with the use of orotracheal intubation and a self-expandable valve system. Staphylococci and enterococci were the most common agents. Although most patients presented at least 1 complication of IE, valve intervention was performed in a minority of patients, and nearly half of the patients died during the hospitalization period.

Keywords: endocarditis; heart valves; transcatheter aortic valve implantation.

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Comment in

Letter by Thuny and Cautela Regarding Article, "Infective Endocarditis After Transcatheter Aortic Valve Implantation: Results From a Large Multicenter Registry".
Thuny F, Cautela J. Thuny F, et al. Circulation. 2015 Dec 8;132(23):e369. doi: 10.1161/CIRCULATIONAHA.115.017333. Circulation. 2015. PMID: 26644252 No abstract available.
Letter by Pericas et al Regarding Article, "Infective Endocarditis After Transcatheter Aortic Valve Implantation: Results From a Large Multicenter Registry".
Pericas JM, Falces C, Miró JM; Hospital Clinic of Barcelona Endocarditis Study Group*. Pericas JM, et al. Circulation. 2015 Dec 8;132(23):e370-1. doi: 10.1161/CIRCULATIONAHA.115.016804. Circulation. 2015. PMID: 26644253 No abstract available.
Response to Letters Regarding Article, "Infective Endocarditis After Transcatheter Aortic Valve Implantation: Results From a Large Multicenter Registry".
Amat-Santos IJ, Messika-Zeitoun D, Eltchaninoff H, Kapadia S, Lerakis S, Cheema AN, Gutiérrez-Ibanes E, Munoz A, Pan M, Webb JG, Herrmann H, Kodali S, Nombela-Franco L, Tamburino C, Jilaihawi H, Masson JB, Sandoli de Brito F, Cristina Ferreira M, Lima VC, Mangione JA, Iung B, Vahanian A, Durand E, Tuzcu M, Hayek SS, Angulo-Llanos R, Gómez-Doblas JJ, Castillo JC, Dvir D, Leon MB, Garcia E, Cobiella J, Barbanti M, Makkar R, Barbosa Ribeiro H, Urena M, Dumont E, Pibarot P, Lopez J, San Roman A, Rodés-Cabau J. Amat-Santos IJ, et al. Circulation. 2015 Dec 8;132(23):e372-4. doi: 10.1161/CIRCULATIONAHA.115.018432. Circulation. 2015. PMID: 26644254 No abstract available.

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Infective endocarditis after transcatheter aortic valve implantation: results from a large multicenter registry

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Infective endocarditis after transcatheter aortic valve implantation: results from a large multicenter registry

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