Prosthetic Valve Endocarditis After TAVR and SAVR
Key result
TAVR had a similar incidence of prosthetic valve endocarditis compared to SAVR (5.21 vs 4.10 per 1000 person-years; incident rate ratio 1.27, 95% CI 0.70-2.32, P=0.44).
Why the study?
Prosthetic valve endocarditis is a rare but critical cause of valve failure and death after TAVR and SAVR, warranting further analysis of its incidence, risk factors, and outcomes in modern experience.
Does TAVR compared to SAVR alter the incidence of prosthetic valve endocarditis in patients with severe aortic stenosis?
Population
8530 patients with severe aortic stenosis in PARTNER 1 and 2 trials and registries
Comparison
TAVR vs SAVR
Design
Pooled cohort analysis of trials and registries
Follow-up
Mean 2.69±1.55 years
Authors
Discussion
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Implication
Similar endocarditis rates should not yet influence TAVR versus SAVR selection; leaves open need for randomized confirmation.
Study Design
Type
Cohort (n=8,530)
Multicenter
Yes
Structured PICO
Does TAVR compared to SAVR alter the incidence of prosthetic valve endocarditis in patients with severe aortic stenosis?
P
Population
8,530 patients with severe aortic stenosis treated with TAVR or SAVR from the PARTNER trials and registries, followed for a mean of 2.69 years.
E
Exposure
Transcatheter aortic valve replacement (TAVR)
C
Comparator
Surgical aortic valve replacement (SAVR)
O
Outcome
Development of prosthetic valve endocarditis (PVE) adjudicated by a clinical events committee based on modified Duke Criteriahard clinical
Main Result
Relative Risk: 1.27 (95% CI 0.7–2.32)
Absolute Event Rate: 5.21% vs 4.1%
p-value: p=0.44
Prosthetic valve endocarditis remains a rare but highly fatal complication after aortic valve replacement, with no significant difference in incidence, predictors, or temporal risk between TAVR and SAVR.
Cite This Study
Summers et al. (2019) conducted a cohort in Severe aortic stenosis (n=8,530). TAVR vs. SAVR was evaluated on Incidence of prosthetic valve endocarditis (PVE) (incident rate ratio 1.27, 95% CI 0.70-2.32, p=0.44). TAVR had a similar incidence of prosthetic valve endocarditis compared to SAVR (5.21 vs 4.10 per 1000 person-years; incident rate ratio 1.27, 95% CI 0.70-2.32, P=0.44).