Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands.
Aortic valve stenosis
Prosthetic valve endocarditis
Structural heart intervention
Structural heart valve disease
Transcatheter aortic valve replacement
Journal
Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
ISSN: 1568-5888
Titre abrégé: Neth Heart J
Pays: Netherlands
ID NLM: 101095458
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
26
4
2020
medline:
26
4
2020
entrez:
26
4
2020
Statut:
ppublish
Résumé
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. 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. 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). PVE in patients receiving TAVR is a relatively rare complication and has a high mortality rate.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
PVE in patients receiving TAVR is a relatively rare complication and has a high mortality rate.
Identifiants
pubmed: 32333256
doi: 10.1007/s12471-020-01420-2
pii: 10.1007/s12471-020-01420-2
pmc: PMC7494686
doi:
Types de publication
Journal Article
Langues
eng
Pagination
520-525Références
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