Very early infective endocarditis after transcatheter aortic valve replacement - Université de Rennes
Article Dans Une Revue Clinical Research in Cardiology Année : 2022

Very early infective endocarditis after transcatheter aortic valve replacement

Vassili Panagides
Francesco Giannini
Martin Landt
  • Fonction : Auteur
Jan Malte Sinning
  • Fonction : Auteur
Asim N. Cheema
  • Fonction : Auteur
Luis Nombela-Franco
Francisco Campelo-Parada
Erika Munoz-Garcia
  • Fonction : Auteur
Howard C. Herrmann
  • Fonction : Auteur
Lars Sondergaard
  • Fonction : Auteur
Dominique Himbert
  • Fonction : Auteur
Azeem Latib
Clement Servoz
  • Fonction : Auteur
Josep Rodes-Cabau

Résumé

Background - Scarce data exist about early infective endocarditis (IE) after trans-catheter aortic valve replacement (TAVR). Objective - The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR. Methods - This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR. Results - Ninety-one patients (15.7%) had VE-IE. Factors associated with VE-IE (vs. delayed IE (D-IE)) were female gender (p = 0.047), the use of self-expanding valves (p < 0.001), stroke (p = 0.019), and sepsis (p < 0.001) after TAVR. Staphylococcus aureus was the main pathogen among VE-IE patients (35.2% vs. 22.7% in the D-IE group, p = 0.012), and 31.2% of Staphylococcus aureus infections in the VE-IE group were methicillin-resistant (vs. 14.3% in the D-IE group, p = 0.001). The second-most common germ was enterococci (34.1% vs. 24.4% in D-IE cases, p = 0.05). VE-IE was associated with very high in-hospital (44%) and 1-year (54%) mortality rates. Acute renal failure following TAVR (p = 0.001) and the presence of a non-enterococci pathogen (p < 0.001) were associated with an increased risk of death. Conclusion - A significant proportion of IE episodes following TAVR occurs within a few weeks following the procedure and are associated with dismal outcomes. Some baseline and TAVR procedural factors were associated with VE-IE, and Staphylococcus aureus and enterococci were the main causative pathogens. These results may help to select the more appropriate antibiotic prophylaxis in TAVR procedures and guide the initial antibiotic therapy in those cases with a clinical suspicion of IE. Very early infective endocarditis after trans-catheter aortic valve replacement. VE-IE indicates very early infective endocarditis (≤30 days post TAVR). D-IE indicates delayed infective endocarditis.
Fichier non déposé

Dates et versions

hal-03629467 , version 1 (04-04-2022)

Identifiants

Citer

Vassili Panagides, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, et al.. Very early infective endocarditis after transcatheter aortic valve replacement. Clinical Research in Cardiology, 2022, 111 (10), pp.1087-1097. ⟨10.1007/s00392-022-01998-0⟩. ⟨hal-03629467⟩
20 Consultations
0 Téléchargements

Altmetric

Partager

More