Cargando…

Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases

BACKGROUND: Transcatheter aortic valve replacement–associated infective endocarditis (TAVR-IE) is a relatively rare complication of TAVR. Little is known about the characteristics of early, intermediate, and late-onset TAVR-IE. METHODS: We studied the risk factors, microbiological patterns, and diag...

Descripción completa

Detalles Bibliográficos
Autores principales: Kaur, Simrat, Samra, Gursharan Singh, Kaur, Manpreet, Shrestha, Nabin K., Gordon, Steven, Tuzcu, E. Murat, Kapadia, Samir, Krishnaswamy, Amar, Reed, Grant W., Puri, Rishi, Svensson, Lars G., Jaber, Wael A., Griffin, Brian P., Xu, Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236854/
https://www.ncbi.nlm.nih.gov/pubmed/37273476
http://dx.doi.org/10.1016/j.shj.2022.100005
_version_ 1785053034355621888
author Kaur, Simrat
Samra, Gursharan Singh
Kaur, Manpreet
Shrestha, Nabin K.
Gordon, Steven
Tuzcu, E. Murat
Kapadia, Samir
Krishnaswamy, Amar
Reed, Grant W.
Puri, Rishi
Svensson, Lars G.
Jaber, Wael A.
Griffin, Brian P.
Xu, Bo
author_facet Kaur, Simrat
Samra, Gursharan Singh
Kaur, Manpreet
Shrestha, Nabin K.
Gordon, Steven
Tuzcu, E. Murat
Kapadia, Samir
Krishnaswamy, Amar
Reed, Grant W.
Puri, Rishi
Svensson, Lars G.
Jaber, Wael A.
Griffin, Brian P.
Xu, Bo
author_sort Kaur, Simrat
collection PubMed
description BACKGROUND: Transcatheter aortic valve replacement–associated infective endocarditis (TAVR-IE) is a relatively rare complication of TAVR. Little is known about the characteristics of early, intermediate, and late-onset TAVR-IE. METHODS: We studied the risk factors, microbiological patterns, and diagnostic and treatment strategies in patients with early (<60 days), intermediate (60-365 days), and late-onset (>1 year) TAVR-IE. RESULTS: Ten out of 494 definite cases of prosthetic valve IE between 2007 and 2019 were confirmed to have TAVR-IE from the IE registry at our center. The mean age was 78.1 ± 13.7 years, with 50% being female. The mean Society of Thoracic Surgeons risk score was 7.8 ± 5.7. Most (60%) TAVR-IE cases had an intermediate onset, with Staphylococcus aureus being the most common organism (66.6%). 18-fluorodeoxyglucose positron emission tomography aided in diagnosis of TAVR-IE in 20% of cases. Mortality due to IE was observed in 40% of cases. Most of the patients underwent conservative management, and 37.5% survived over a mean follow-up of 709 ± 453 days. Two patients underwent surgery, of whom one died on day 30 postoperatively from sepsis. Mortality due to IE occurred in 25% of cases in the early and intermediate-onset groups, while there was 100% mortality in the late-onset group. CONCLUSIONS: In a single-center cohort, most TAVR-IE cases had an intermediate onset, with Staphylococcus aureus being the most common organism. Understanding timing of TAVR-IE may have important prognostic implications.
format Online
Article
Text
id pubmed-10236854
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-102368542023-06-02 Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases Kaur, Simrat Samra, Gursharan Singh Kaur, Manpreet Shrestha, Nabin K. Gordon, Steven Tuzcu, E. Murat Kapadia, Samir Krishnaswamy, Amar Reed, Grant W. Puri, Rishi Svensson, Lars G. Jaber, Wael A. Griffin, Brian P. Xu, Bo Struct Heart Original Research BACKGROUND: Transcatheter aortic valve replacement–associated infective endocarditis (TAVR-IE) is a relatively rare complication of TAVR. Little is known about the characteristics of early, intermediate, and late-onset TAVR-IE. METHODS: We studied the risk factors, microbiological patterns, and diagnostic and treatment strategies in patients with early (<60 days), intermediate (60-365 days), and late-onset (>1 year) TAVR-IE. RESULTS: Ten out of 494 definite cases of prosthetic valve IE between 2007 and 2019 were confirmed to have TAVR-IE from the IE registry at our center. The mean age was 78.1 ± 13.7 years, with 50% being female. The mean Society of Thoracic Surgeons risk score was 7.8 ± 5.7. Most (60%) TAVR-IE cases had an intermediate onset, with Staphylococcus aureus being the most common organism (66.6%). 18-fluorodeoxyglucose positron emission tomography aided in diagnosis of TAVR-IE in 20% of cases. Mortality due to IE was observed in 40% of cases. Most of the patients underwent conservative management, and 37.5% survived over a mean follow-up of 709 ± 453 days. Two patients underwent surgery, of whom one died on day 30 postoperatively from sepsis. Mortality due to IE occurred in 25% of cases in the early and intermediate-onset groups, while there was 100% mortality in the late-onset group. CONCLUSIONS: In a single-center cohort, most TAVR-IE cases had an intermediate onset, with Staphylococcus aureus being the most common organism. Understanding timing of TAVR-IE may have important prognostic implications. Elsevier 2022-03-17 /pmc/articles/PMC10236854/ /pubmed/37273476 http://dx.doi.org/10.1016/j.shj.2022.100005 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Kaur, Simrat
Samra, Gursharan Singh
Kaur, Manpreet
Shrestha, Nabin K.
Gordon, Steven
Tuzcu, E. Murat
Kapadia, Samir
Krishnaswamy, Amar
Reed, Grant W.
Puri, Rishi
Svensson, Lars G.
Jaber, Wael A.
Griffin, Brian P.
Xu, Bo
Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases
title Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases
title_full Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases
title_fullStr Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases
title_full_unstemmed Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases
title_short Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases
title_sort transcatheter aortic valve replacement–associated infective endocarditis: comparison of early, intermediate, and late-onset cases
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236854/
https://www.ncbi.nlm.nih.gov/pubmed/37273476
http://dx.doi.org/10.1016/j.shj.2022.100005
work_keys_str_mv AT kaursimrat transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT samragursharansingh transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT kaurmanpreet transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT shresthanabink transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT gordonsteven transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT tuzcuemurat transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT kapadiasamir transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT krishnaswamyamar transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT reedgrantw transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT puririshi transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT svenssonlarsg transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT jaberwaela transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT griffinbrianp transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases
AT xubo transcatheteraorticvalvereplacementassociatedinfectiveendocarditiscomparisonofearlyintermediateandlateonsetcases