Infectious Endocarditis After Transcatheter Aortic Valve Replacement: Epidemiology and Outcomes

With the expansion of the indications of transcatheter aortic valve replacement (TAVR), it is being increasingly performed in older patients with aortic stenosis to improve their quality of life. However, TAVR is not without serious complications. Despite being infrequent, prosthetic valve endocarditis after TAVR is a deadly complication associated with high rates of mortality related to a delayed diagnosis from variable clinical presentations and nonconfirmatory imaging findings. Furthermore, lower intervention rates in these patients, due to their high surgical risk, increases overall mortality. Clinicians should be aware of the differences in presentation and postprocedural anatomical considerations that delay the diagnosis of infectious endocarditis post TAVR. Studies evaluating the role of the procedural setting, implant and access type, and periprocedural antibiotic prophylaxis on the development of prosthetic valve endocarditis, and consensus guidelines that address the appropriate diagnosis and management of prosthetic valve endocarditis after TAVR, are needed.
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research

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ConclusionIn a large cohort of patients with severe symptomatic aortic stenosis from the PARTNER 2 trial and registries, all ‐cause and cardiovascular mortality as well as infective endocarditis rates at 2 years were higher in patients with recent HF hospitalization.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Publication date: Available online 12 February 2020Source: The Annals of Thoracic SurgeryAuthor(s): Fausto Biancari., Antti Valtola, Tatu Juvonen, Annastiina Husso, Sebastian Dahlbacka, Teemu Laakso, Maina P. Jalava, Tuomas Tauriainen, Tuomas Ahvenvaara, Eeva-Maija Kinnunen, Matti Niemelä, Timo Mäkikallio, Markku Eskola, Marko P.O. Virtanen, Pasi Maaranen, Stefano Rosato, Vesa Anttila, Antti Vento, Juhani Airaksinen, Peter RaivioAbstractBackgroundRecent surgical bovine pericardial prostheses are widely used in spite of limited data on their long-term durability.MethodsThis is a comparative analysis of the outcome...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
aivio P Abstract BACKGROUND: Recent surgical bovine pericardial prostheses are widely used in spite of limited data on their long-term durability. METHODS: This is a comparative analysis of the outcome of the Trifecta and Perimount Magna Ease bioprostheses from the FinnValve registry, a Finnish nationwide database including patients with aortic stenosis who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis between 2008 and 2017. RESULTS: Overall 2216 patients (mean age, 74.1±6.7 years; age
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
AbstractAn 83-year-old man had aortic valve replacement for aortic stenosis with a pericardial bioprosthesis and subsequent implantation of a CoreValve ™ prosthesis as a valve-in-valve procedure. Approximately 4 years later, he developed endocarditis on the CoreValve™ with severe prosthetic stenosis, a periannular abscess and systemic embolization. At reoperation both prostheses were removed and another bioprosthesis inserted after reconstruct ion of the aortic root. Endocarditis after transaortic valve implantation is an uncommon event with dismal prognosis. Infection of a self-expandable device as a valv...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
We examined patients with chronic kidney disease and severe aortic stenosis undergoing SAVR or TAVR procedure between 2007-2017; excluding age90, dialysis, endocarditis, non-aortic valve stenosis, or patients died within 48-hours post-procedure.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Acute kidney recovery (AKR) is a recently described phenomenon observed after transcatheter aortic valve replacement (TAVR) and is more frequent than acute kidney injury (AKI). To determine the incidence and predictors of AKR between surgical aortic valve replacement (SAVR) and TAVR, we examined patients with chronic kidney disease and severe aortic stenosis who underwent SAVR or TAVR procedure between 2007 and 2017; excluding age90, dialysis, endocarditis, non-aortic valve stenosis, or patients died within 48-hours postprocedure.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
With both Edwards Sapien 3 (Edwards Lifesciences, Irvine, Calif) and Medtronic CoreValve Evolut R (Medtronic, Minneapolis, Minn) valves now commercially available for use in low-risk patients, transcatheter aortic valve replacement will quickly become the procedure of choice for virtually every patient with severe aortic stenosis, independent of age, risk, or valve pathology (save for endocarditis). As its use increases in those with longer life expectancy, some valves will inevitably fail. On the heels of previous studies in which their group evaluated the hemodynamic properties of transcatheter valves placed both as isol...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
Heyde described aortic stenosis and gastrointestinal bleeding in the 1950s. Since then, a link with intestinal angiodysplasia and abnormalities of von Willebrand factor (VWF) has been noted. Loss of the highest-molecular-weight multimers of VWF and bleeding also have been described in subaortic stenosis in hypertrophic cardiomyopathy, in isolated mitral and aortic insufficiency, in endocarditis, in patients with prosthetic valve stenosis or regurgitation, and in patients with left ventricular assist devices (LVADs). Bleeding tends to recur with local treatment of angiodysplasias, whereas cardiac repair or removal of LVAD e...
Source: Clinics in Geriatric Medicine - Category: Geriatrics Authors: Source Type: research
AbstractInfective endocarditis (IE) in the pediatric population can present as  a life-threatening condition. Optimal timing for surgical intervention should consider surgical risks versus the risk of neurologic complications. We herein report our experience with this group of critically ill children. Retrospective analysis of patient charts of all patients who underwent urge nt surgical treatment of aortic IE from 1994 to 2014 was performed. Nine patients with acute storming IE of the aortic valve or the ascending aorta were urgently operated (eight normal heart, one congenital aortic stenosis), age ranged from 8&nbs...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
CONCLUSIONS: The Mosaic bioprosthesis has shown excellent durability over two decades of clinical use, with a negligible incidence of valve degeneration and need for reoperation. Thus, it may be considered a valid option for AVR, especially in elderly patients. PMID: 30560605 [PubMed - in process]
Source: Journal of Heart Valve Disease - Category: Cardiology Tags: J Heart Valve Dis Source Type: research
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