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Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands
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 stu...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bohn Stafleu van Loghum
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494686/ https://www.ncbi.nlm.nih.gov/pubmed/32333256 http://dx.doi.org/10.1007/s12471-020-01420-2 |
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author | Brouwer, J. van den Brink, F. S. Nijenhuis, V. J. Vossenberg, T. N. Delewi, R. van Mourik, M. S. den Heijer, P. Tanis, W. Kievit, P. C. Holvoet, W. Hermanides, R. S. ten Berg, J. M. |
author_facet | Brouwer, J. van den Brink, F. S. Nijenhuis, V. J. Vossenberg, T. N. Delewi, R. van Mourik, M. S. den Heijer, P. Tanis, W. Kievit, P. C. Holvoet, W. Hermanides, R. S. ten Berg, J. M. |
author_sort | Brouwer, J. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7494686 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-74946862020-09-28 Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands Brouwer, J. van den Brink, F. S. Nijenhuis, V. J. Vossenberg, T. N. Delewi, R. van Mourik, M. S. den Heijer, P. Tanis, W. Kievit, P. C. Holvoet, W. Hermanides, R. S. ten Berg, J. M. Neth Heart J Original Article 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. Bohn Stafleu van Loghum 2020-04-24 2020-10 /pmc/articles/PMC7494686/ /pubmed/32333256 http://dx.doi.org/10.1007/s12471-020-01420-2 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Brouwer, J. van den Brink, F. S. Nijenhuis, V. J. Vossenberg, T. N. Delewi, R. van Mourik, M. S. den Heijer, P. Tanis, W. Kievit, P. C. Holvoet, W. Hermanides, R. S. ten Berg, J. M. Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands |
title | Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands |
title_full | Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands |
title_fullStr | Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands |
title_full_unstemmed | Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands |
title_short | Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands |
title_sort | incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the netherlands |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494686/ https://www.ncbi.nlm.nih.gov/pubmed/32333256 http://dx.doi.org/10.1007/s12471-020-01420-2 |
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