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Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis

Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016...

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Autores principales: Rösch, Romina Maria, Brendel, Lena, Buschmann, Katja, Vahl, Christian-Friedrich, Treede, Hendrik, Dohle, Daniel-Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456027/
https://www.ncbi.nlm.nih.gov/pubmed/37629220
http://dx.doi.org/10.3390/jcm12165177
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author Rösch, Romina Maria
Brendel, Lena
Buschmann, Katja
Vahl, Christian-Friedrich
Treede, Hendrik
Dohle, Daniel-Sebastian
author_facet Rösch, Romina Maria
Brendel, Lena
Buschmann, Katja
Vahl, Christian-Friedrich
Treede, Hendrik
Dohle, Daniel-Sebastian
author_sort Rösch, Romina Maria
collection PubMed
description Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016 and July 2019, ten patients underwent surgery due to prosthetic-valve endocarditis after TAVR. They were identified in our institutional database and analyzed. Results: Infective endocarditis was diagnosed 17 ± 16 month after TAVR. Mean age was 79 ± 4.4 years. Microbiological detection showed 6/10 positive blood cultures for enterococcus faecalis. Median EuroScore II was 24.64%. The mean size of the surgically replaced aortic prosthesis was 23.6 ± 1.3 and that of the TAVR was 28.4 ± 2.3 mm. The surgically implanted aortic valves had a mean gradient of 8.5 ± 2.2 mmHg. One patient died in hospital due to septic multiorgan failure. After discharge, all patients survived with a mean follow-up of 9 ± 8 month. Conclusions: With a rising number of patients after TAVR, prosthetic-valve endocarditis will increasingly occur in patients who were previously considered high or intermediate risk. Our results show that patients with TAVR infective endocarditis can be operated on with good results. Surgical therapy should not be withheld from TAVR patients with infective endocarditis.
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spelling pubmed-104560272023-08-26 Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis Rösch, Romina Maria Brendel, Lena Buschmann, Katja Vahl, Christian-Friedrich Treede, Hendrik Dohle, Daniel-Sebastian J Clin Med Brief Report Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016 and July 2019, ten patients underwent surgery due to prosthetic-valve endocarditis after TAVR. They were identified in our institutional database and analyzed. Results: Infective endocarditis was diagnosed 17 ± 16 month after TAVR. Mean age was 79 ± 4.4 years. Microbiological detection showed 6/10 positive blood cultures for enterococcus faecalis. Median EuroScore II was 24.64%. The mean size of the surgically replaced aortic prosthesis was 23.6 ± 1.3 and that of the TAVR was 28.4 ± 2.3 mm. The surgically implanted aortic valves had a mean gradient of 8.5 ± 2.2 mmHg. One patient died in hospital due to septic multiorgan failure. After discharge, all patients survived with a mean follow-up of 9 ± 8 month. Conclusions: With a rising number of patients after TAVR, prosthetic-valve endocarditis will increasingly occur in patients who were previously considered high or intermediate risk. Our results show that patients with TAVR infective endocarditis can be operated on with good results. Surgical therapy should not be withheld from TAVR patients with infective endocarditis. MDPI 2023-08-09 /pmc/articles/PMC10456027/ /pubmed/37629220 http://dx.doi.org/10.3390/jcm12165177 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Rösch, Romina Maria
Brendel, Lena
Buschmann, Katja
Vahl, Christian-Friedrich
Treede, Hendrik
Dohle, Daniel-Sebastian
Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
title Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
title_full Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
title_fullStr Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
title_full_unstemmed Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
title_short Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
title_sort surgery for infective endocarditis after primary transcatheter aortic-valve replacement—a retrospective single-center analysis
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456027/
https://www.ncbi.nlm.nih.gov/pubmed/37629220
http://dx.doi.org/10.3390/jcm12165177
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