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Journal Articles Journal of the American College of Cardiology Year : 2022

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)
Mohamed Abdel-Wahab
Nikolaj Ihlemann
  • Function : Author
Costanza Pellegrini
  • Function : Author
Francesco Giannini
Tomasz Gasior
  • Function : Author
Wojtek Wojakowski
  • Function : Author
Martin Landt
  • Function : Author
Jan Malte Sinning
  • Function : Author
Asim Cheema
  • Function : Author
Luis Nombela-Franco
Erika Munoz-Garcia
  • Function : Author
Howard Herrmann
  • Function : Author
Luca Testa
Won-Keun Kim
  • Function : Author
Juan Carlos Castillo
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Alberto Alperi
Antonio Bartorelli
  • Function : Author
Samir Kapadia
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
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
Utz Kappert
Marco Barbanti
Jean-Bernard Masson
  • Function : Author
Frédéric Maes
  • Function : Author
Claudia Fiorina
  • Function : Author
Antonio Miceli
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
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Maria-Cristina Ferreira
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Valter Correia de Lima
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Alexandre Abizaid
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Marcos Antonio Marino
  • Function : Author
Vinicius Esteves
  • Function : Author
Julio Andrea
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Roger Godinho
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Fernando Alfonso
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Lars Søndergaard
  • Function : Author
Dominique Himbert
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Oliver Husser
  • Function : Author
Azeem Latib
Clement Servoz
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Isaac Pascual
Saif Siddiqui
  • Function : Author
Paolo Olivares
  • Function : Author
Rosana Hernandez-Antolin
  • Function : Author
John Webb
  • Function : Author
Sandro Sponga
  • Function : Author
Raj Makkar
Annapoorna Kini
  • Function : Author
Marouane Boukhris
  • Function : Author
David Holzhey
  • Function : Author

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.
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Dates and versions

hal-03593617 , version 1 (02-03-2022)

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Norman Mangner, David Del Val, Mohamed Abdel-Wahab, Lisa Crusius, Eric Durand, et al.. Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation. Journal of the American College of Cardiology, 2022, 79 (8), pp.772-785. ⟨10.1016/j.jacc.2021.11.056⟩. ⟨hal-03593617⟩
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