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. 2020 Oct;28(10):520-525.
doi: 10.1007/s12471-020-01420-2.

Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands

J Brouwer  1 , F S van den Brink  2   3 , V J Nijenhuis  2 , T N Vossenberg  3 , R Delewi  4 , M S van Mourik  4 , P den Heijer  5 , W Tanis  6 , P C Kievit  7 , W Holvoet  8 , R S Hermanides  9 , J M Ten Berg  2
Affiliations

Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands

J Brouwer et al. Neth Heart J. 2020 Oct.

Abstract

Background: Transcatheter aortic valve replacement (TAVR) is increasingly being used as an alternative to conventional surgical valve replacement. Prosthetic valve endocarditis (PVE) is a rare but feared complication after TAVR, with reported first-year incidences varying from 0.57 to 3.1%. This study was performed to gain insight into the incidence and outcome of PVE after TAVR in the Netherlands.

Methods: A multicentre retrospective registry study was performed. All patients who underwent TAVR in the period 2010-2017 were screened for the diagnosis of infective endocarditis in the insurance database and checked for the presence of PVE before analysis of general characteristics, PVE parameters and outcome.

Results: A total of 3968 patients who underwent TAVR were screened for PVE. During a median follow-up of 33.5 months (interquartile range (IQR) 22.8-45.8), 16 patients suffered from PVE (0.4%), with a median time to onset of 177 days (IQR 67.8-721.3). First-year incidence was 0.24%, and the overall incidence rate was 0.14 events per 1000 person-years. Overall mortality during follow-up in our study was 31%, of which 25% occurred in hospital. All patients were treated conservatively with intravenous antibiotics alone, and none underwent a re-intervention. Other complications of PVE occurred in 5 patients (31%) and included aortic abscess (2), decompensated heart failure (2) and cerebral embolisation (1).

Conclusion: PVE in patients receiving TAVR is a relatively rare complication and has a high mortality rate.

Keywords: Aortic valve stenosis; Prosthetic valve endocarditis; Structural heart intervention; Structural heart valve disease; Transcatheter aortic valve replacement.

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Conflict of interest statement

J. Brouwer, F.S. van den Brink, V.J. Nijenhuis, T.N. Vossenberg, R. Delewi, M.S. van Mourik, P. den Heijer, W. Tanis, P.C. Kievit, W. Holvoet, R.S. Hermanides and J.M. ten Berg declare that they have no competing interests.

References

    1. Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–1607. - PubMed
    1. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374(17):1609–1620. - PubMed
    1. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–2198. - PubMed
    1. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380(18):1695–1705. - PubMed
    1. Popma JJ, Deeb GM, Yakubov SJ, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med. 2019;380(18):1706–1715. - PubMed

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