Surgical aortic valve replacement was associated with a higher cumulative incidence of infective endocarditis at 60 months compared to TAVI (2.4% vs 1.5%; HR 1.60; p<0.001).
Cohort (n=106,157)
Yes
Does surgical aortic valve replacement compared to transcatheter aortic valve implantation increase the risk of infective endocarditis in patients undergoing first aortic valve replacement?
Infective endocarditis is a rare complication following aortic valve replacement, but its incidence is significantly higher after surgical replacement compared to transcatheter implantation.
Effect estimate: HR 1.60
Absolute Event Rate: 2.4% vs 1.5%
p-value: p=<0.001
OBJECTIVE: To define the incidence and risk factors for infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). METHODS: All patients who underwent first SAVR or TAVI in England between 2007 and 2016 were identified from the NICOR databases. Hospital admissions with a primary diagnosis of IE were identified by linkage with the NHS Hospital Episode Statistics database. Approval was obtained from the NHS Research Ethics Committee. RESULTS: 2057 of 91 962 patients undergoing SAVR developed IE over a median follow-up of 53.9 months-an overall incidence of 4.81 95% CI 4.61 to 5.03 per 1000 person-years. Correspondingly, 140 of 14 195 patients undergoing TAVI developed IE over a median follow-up of 24.5 months-an overall incidence of 3.57 95% CI 3.00 to 4.21 per 1000 person-years. The cumulative incidence of IE at 60 months was higher after SAVR than after TAVI (2.4% 95% CI 2.3 to 2.5 vs 1.5% 95% CI 1.3 to 1.8, HR 1.60, p<0.001). Across the entire cohort, SAVR remained an independent predictor of IE after multivariable adjustment. Risk factors for IE included younger age, male sex, atrial fibrillation, and dialysis. CONCLUSIONS: IE is a rare complication of SAVR and TAVI. In our population, the incidence of IE was higher after SAVR than after TAVI.
Cahill et al. (Thu,) conducted a cohort in Aortic valve replacement (n=106,157). Surgical aortic valve replacement (SAVR) vs. Transcatheter aortic valve implantation (TAVI) was evaluated on Cumulative incidence of infective endocarditis at 60 months (HR 1.60, p=<0.001). Surgical aortic valve replacement was associated with a higher cumulative incidence of infective endocarditis at 60 months compared to TAVI (2.4% vs 1.5%; HR 1.60; p<0.001).