Key result
TAVI had similar rates of respiratory and urinary infections compared to SAVR, but fewer wound healing disorders (1% vs 8%, P=0.035) and higher 2-year mortality (28% vs 16%, P=0.048).
Why the study?
Does TAVI compared to SAVR reduce infectious complications in patients with aortic stenosis?
Cohort (n=200)
No
Does TAVI compared to SAVR reduce infectious complications in patients with aortic stenosis?
TAVI and SAVR have similar rates of most early and mid-term infectious complications, though SAVR is associated with a higher incidence of wound healing disorders.
No difference in infectious complications seen between TAVI and SAVR; leaves open whether procedural choice influences infection risk in larger cohorts.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is the standard therapy for high-risk patients with aortic stenosis (AS). TAVI-outcomes are widely investigated in comparison to surgical aortic valve replacement (SAVR), but less is known about infectious complications after TAVI. We aimed to compare early and mid-term infectious outcomes of patients undergoing TAVI or SAVR. METHODS: The present study is a prospective single-centre study including 200 consecutive patients between 06/2014-03/2015 undergoing TAVI (either transfemoral or transapical and transaortic, n=47+53=100) or SAVR (either isolated or concomitant with CABG, n=52+48=100). The mean age and log. EuroSCORE were significantly different between both groups (81±6 versus 69±11 years, P<0.001 and 23.1%±13.8% versus 8.7%±9.5%, P<0.001). Primary endpoints included wound healing disorders, respiratory and urinary tract infections and incidence of endocarditis or sepsis within hospital stay. Secondary endpoints included infectious parameters, infectious related rehospitalisation and 2-year mortality. RESULTS: Primary endpoints showed no difference in overall TAVI- versus SAVR-groups regarding respiratory- (14% versus 19%, P=0.45), urinary-tract (7% versus 4%, P=0.54) infections, sepsis (5% versus 6%, P=1.0), endocarditis (0% versus 1%, P=1.0) or 30-day mortality (10% versus 4%, P=0.09), except for wound disorders, which were significantly lower in the TAVI-group (1% versus 8%, P=0.035), respectively. Secondary endpoints reported no difference regarding infectious related rehospitalisation (4% versus 4%, P=1.0), but significantly higher 2-year mortality (28% versus 16%, P=0.048) in the TAVI-group. CONCLUSIONS: So far, little has been studied about infectious complications after TAVI. This study reports no difference between the overall TAVI and SAVR groups regarding infectious complications. However, SAVR group show more wound healing disorders but less mortality than TAVI group.
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Shehada et al. (2018) conducted a cohort in Aortic stenosis (n=200). Transcatheter aortic valve implantation (TAVI) vs. Surgical aortic valve replacement (SAVR) was evaluated on Wound healing disorders, respiratory and urinary tract infections and incidence of endocarditis or sepsis within hospital stay. TAVI had similar rates of respiratory and urinary infections compared to SAVR, but fewer wound healing disorders (1% vs 8%, P=0.035) and higher 2-year mortality (28% vs 16%, P=0.048).
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