Conservative and surgical treatments for infective endocarditis after TAVI showed no significant difference in in-hospital (RR: 0.95) and 1-year mortality (RR: 0.98).
Does surgical treatment improve mortality compared to conservative treatment in patients with infective endocarditis after transcatheter aortic valve implantation?
Surgical and conservative management of infective endocarditis after TAVI are associated with similar in-hospital and 1-year mortality rates.
Absolute Event Rate: 0% vs 0%
Abstract Background Infective endocarditis after transcatheter aortic valve implantation (TAVI-IE) is a rare but serious complication associated with high morbidity and mortality. Strategies for managing TAVI-IE vary significantly, with the optimal therapeutic approach remaining a subject of debate. Therefore, the aim of this meta-analysis is to compare the outcomes between conservative and surgical treatment in patients with TAVI-IE, in order to clarify the optimal therapeutic approach in this population. Methods A systematic review in three different databases (PubMed, Scopus, Web of Science) was conducted, in order to identify studies that evaluated the differences between conservative and surgical treatment in the outcome of patients with TAVI-IE. After selecting all available studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a meta-analysis was performed. The outcomes were reported as risk ratios (RR) along with their respective 95% confidence intervals (95%CI). Results A total of 13 studies were selected for data extraction and inclusion in the meta-analysis. No significant difference was observed regarding the in-hospital (RR: 0.95, 95% CI: 0.78-1.17, p=0.62, I2=0%) and 1-year mortality (RR: 0.98, 95%CI: 0.84-1.15, p=0.80, I2=0%) between conservative and surgical treatment in patients with TAVI-IE. Moreover, no evidence of publication bias was identified based on the Egger’s and Begg’s test (all p0.05). Finally, based on sensitivity leave-one-out analyses, no significant variation in the aforementioned results was noted after excluding any individual study. Conclusions This meta-analysis demonstrated the similar outcomes, in regard to mortality, of surgical and conservative management of TAVI-IE. As further studies reporting mortality and adverse event rates are needed to safely conclude, these findings underscore the importance of individualized assessment of each TAVI-IE case, considering patient risk and availability of surgical intervention at each center.
Pyrpyris et al. (Sun,) reported a other. Conservative and surgical treatments for infective endocarditis after TAVI showed no significant difference in in-hospital (RR: 0.95) and 1-year mortality (RR: 0.98).