Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation
Norman Mangner
(1)
,
David Del Val
(2)
,
Mohamed Abdel-Wahab
(3)
,
Lisa Crusius
(1)
,
Eric Durand
(4)
,
Nikolaj Ihlemann
,
Marina Urena
(5)
,
Costanza Pellegrini
,
Francesco Giannini
,
Tomasz Gasior
,
Wojtek Wojakowski
,
Martin Landt
,
Vincent Auffret
(6, 7)
,
Jan Malte Sinning
,
Asim Cheema
,
Luis Nombela-Franco
,
Chekrallah Chamandi
(8)
,
Francisco Campelo-Parada
(9)
,
Erika Munoz-Garcia
,
Howard Herrmann
,
Luca Testa
,
Won-Keun Kim
,
Juan Carlos Castillo
,
Alberto Alperi
,
Didier Tchetche
(10)
,
Antonio Bartorelli
,
Samir Kapadia
,
Stefan Stortecky
,
Ignacio Amat-Santos
,
Harindra Wijeysundera
,
John Lisko
,
Enrique Gutiérrez-Ibanes
,
Vicenç Serra
,
Luisa Salido
,
Abdullah Alkhodair
,
Ugolino Livi
,
Tarun Chakravarty
,
Stamatios Lerakis
,
Victoria Vilalta
,
Ander Regueiro
,
Rafael Romaguera
,
Utz Kappert
,
Marco Barbanti
,
Jean-Bernard Masson
,
Frédéric Maes
,
Claudia Fiorina
,
Antonio Miceli
,
Susheel Kodali
,
Henrique Ribeiro
,
Jose Armando Mangione
,
Fabio Sandoli de Brito
,
Guglielmo Mario Actis Dato
,
Francesco Rosato
,
Maria-Cristina Ferreira
,
Valter Correia de Lima
,
Alexandre Siciliano Colafranceschi
,
Alexandre Abizaid
,
Marcos Antonio Marino
,
Vinicius Esteves
,
Julio Andrea
,
Roger Godinho
,
Fernando Alfonso
,
Helene Eltchaninoff
(4)
,
Lars Søndergaard
,
Dominique Himbert
,
Oliver Husser
,
Azeem Latib
,
Hervé Le Breton
(6, 7)
,
Clement Servoz
,
Isaac Pascual
,
Saif Siddiqui
,
Paolo Olivares
,
Rosana Hernandez-Antolin
,
John Webb
,
Sandro Sponga
,
Raj Makkar
,
Annapoorna Kini
,
Marouane Boukhris
,
Philippe Gervais
(2)
,
Mélanie Côté
(2)
,
David Holzhey
(3)
,
Axel Linke
(1)
,
Josep Rodés-Cabau
(2)
1
TU Dresden -
Technische Universität Dresden = Dresden University of Technology
2 ULaval - Université Laval [Québec]
3 Leipzig University
4 EnVI - Endothélium, valvulopathies et insuffisance cardiaque
5 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
6 LTSI - Laboratoire Traitement du Signal et de l'Image
7 CHU Pontchaillou [Rennes]
8 HEGP - Hôpital Européen Georges Pompidou [APHP]
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 Clinique Pasteur [Toulouse]
2 ULaval - Université Laval [Québec]
3 Leipzig University
4 EnVI - Endothélium, valvulopathies et insuffisance cardiaque
5 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
6 LTSI - Laboratoire Traitement du Signal et de l'Image
7 CHU Pontchaillou [Rennes]
8 HEGP - Hôpital Européen Georges Pompidou [APHP]
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 Clinique Pasteur [Toulouse]
Mohamed Abdel-Wahab
- Function : Author
- PersonId : 779286
- ORCID : 0000-0002-9596-558X
Eric Durand
- Function : Author
- PersonId : 801629
- ORCID : 0000-0001-8171-7959
- IdRef : 096257644
Nikolaj Ihlemann
- Function : Author
Costanza Pellegrini
- Function : Author
Francesco Giannini
- Function : Author
- PersonId : 779290
- ORCID : 0000-0002-6799-1043
Tomasz Gasior
- Function : Author
Wojtek Wojakowski
- Function : Author
Martin Landt
- Function : Author
Jan Malte Sinning
- Function : Author
Asim Cheema
- Function : Author
Luis Nombela-Franco
- Function : Author
- PersonId : 779284
- ORCID : 0000-0003-3438-8907
Chekrallah Chamandi
- Function : Author
- PersonId : 784486
- ORCID : 0000-0001-6668-0158
Francisco Campelo-Parada
- Function : Author
- PersonId : 779609
- ORCID : 0000-0003-1821-0658
Erika Munoz-Garcia
- Function : Author
Howard Herrmann
- Function : Author
Luca Testa
- Function : Author
- PersonId : 779287
- ORCID : 0000-0003-4687-3686
Won-Keun Kim
- Function : Author
Juan Carlos Castillo
- Function : Author
Alberto Alperi
- Function : Author
- PersonId : 807401
- ORCID : 0000-0002-9939-8949
Antonio Bartorelli
- Function : Author
Samir Kapadia
- Function : Author
- PersonId : 779285
- ORCID : 0000-0002-0026-3391
Stefan Stortecky
- Function : Author
Ignacio Amat-Santos
- Function : Author
Harindra Wijeysundera
- Function : Author
John Lisko
- Function : Author
Enrique Gutiérrez-Ibanes
- Function : Author
Vicenç Serra
- Function : Author
Luisa Salido
- Function : Author
- PersonId : 807402
- ORCID : 0000-0002-7914-7210
Abdullah Alkhodair
- Function : Author
Ugolino Livi
- Function : Author
Tarun Chakravarty
- Function : Author
Stamatios Lerakis
- Function : Author
Victoria Vilalta
- Function : Author
Ander Regueiro
- Function : Author
Rafael Romaguera
- Function : Author
- PersonId : 807403
- ORCID : 0000-0002-6413-3502
Utz Kappert
- Function : Author
- PersonId : 807404
- ORCID : 0000-0001-8202-7570
Marco Barbanti
- Function : Author
- PersonId : 779288
- ORCID : 0000-0002-4903-5437
Jean-Bernard Masson
- Function : Author
Frédéric Maes
- Function : Author
Claudia Fiorina
- Function : Author
Antonio Miceli
- Function : Author
- PersonId : 779289
- ORCID : 0000-0002-5666-5402
Susheel Kodali
- Function : Author
Henrique Ribeiro
- Function : Author
Jose Armando Mangione
- Function : Author
Fabio Sandoli de Brito
- Function : Author
Guglielmo Mario Actis Dato
- Function : Author
Francesco Rosato
- Function : Author
Maria-Cristina Ferreira
- Function : Author
Valter Correia de Lima
- Function : Author
Alexandre Siciliano Colafranceschi
- Function : Author
Alexandre Abizaid
- Function : Author
Marcos Antonio Marino
- Function : Author
Vinicius Esteves
- Function : Author
Julio Andrea
- Function : Author
Roger Godinho
- Function : Author
Fernando Alfonso
- Function : Author
Lars Søndergaard
- Function : Author
Dominique Himbert
- Function : Author
Oliver Husser
- Function : Author
Azeem Latib
- Function : Author
- PersonId : 776601
- ORCID : 0000-0001-9035-343X
Clement Servoz
- Function : Author
Isaac Pascual
- Function : Author
- PersonId : 807405
- ORCID : 0000-0001-5433-1364
Saif Siddiqui
- Function : Author
Paolo Olivares
- Function : Author
Rosana Hernandez-Antolin
- Function : Author
John Webb
- Function : Author
Sandro Sponga
- Function : Author
Raj Makkar
- Function : Author
- PersonId : 807406
- ORCID : 0000-0002-6613-519X
Annapoorna Kini
- Function : Author
Marouane Boukhris
- Function : Author
Josep Rodés-Cabau
Connectez-vous pour contacter l'auteur
- Function : Correspondent author
- PersonId : 1022904
Connectez-vous pour contacter l'auteur
Abstract
Background: The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain.Objectives: The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB).Methods: Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE. The study used data from the Infectious Endocarditis after TAVI International Registry.Results: Among 584 patients, 111 patients (19%) were treated with IE-CS and 473 patients (81%) with IE-AB. Compared with IE-AB, IE-CS was not associated with a lower in-hospital mortality (HRunadj: 0.85; 95% CI: 0.58-1.25) and 1-year all-cause mortality (HRunadj: 0.88; 95% CI: 0.64-1.22) in the crude cohort. After adjusting for selection and immortal time bias, IE-CS compared with IE-AB was also not associated with lower mortality rates for in-hospital mortality (HRadj: 0.92; 95% CI: 0.80-1.05) and 1-year all-cause mortality (HRadj: 0.95; 95% CI: 0.84-1.07). Results remained similar when patients with and without TAVI prosthesis involvement were analyzed separately. Predictors for in-hospital and 1-year all-cause mortality included logistic EuroSCORE I, Staphylococcus aureus, acute renal failure, persistent bacteremia, and septic shock.Conclusions: In this registry, the majority of patients with TAVI-IE were treated with antibiotics alone. Cardiac surgery was not associated with an improved all-cause in-hospital or 1-year mortality. The high mortality of patients with TAVI-IE was strongly linked to patients' characteristics, pathogen, and IE-related complications.