Incidence and Outcomes of Infective Endocarditis After Transcatheter or Surgical Aortic Valve Replacement
Key result
Transcatheter aortic valve replacement had a lower 5-year cumulative incidence of infective endocarditis compared to surgical replacement (1.01% vs 1.58%; P=0.047).
Why the study?
Data comparing the frequency and outcomes of infective endocarditis after TAVR compared with SAVR were scarce.
Does TAVR using a self-expanding platform reduce the incidence of infective endocarditis compared to SAVR in patients undergoing aortic valve replacement?
Population
2249 TAVR patients and 1828 SAVR patients
Comparison
TAVR using a supra-annular, self-expanding platform vs SAVR
Design
Pooled analysis of 3 randomized clinical trials and a prospective continued access study
Follow-up
Mean 2.17±1.51 years
Authors
Discussion
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Implication
TAVR with a self-expanding device is associated with a lower cumulative risk of infective endocarditis at 5 years compared to SAVR, though mortality remains high once IE occurs.
Study Design
Type
Meta-Analysis (n=4,077)
Multicenter
Yes
Structured PICO
Does TAVR using a self-expanding platform reduce the incidence of infective endocarditis compared to SAVR in patients undergoing aortic valve replacement?
P
Population
4,077 patients undergoing transcatheter or surgical aortic valve replacement from 3 randomized trials and 1 prospective study, followed for a mean of 2.17 years.
I
Intervention
Transcatheter aortic valve replacement (TAVR) using a supra-annular, self-expanding platform (CoreValve and Evolut)
C
Comparator
Surgical aortic valve replacement (SAVR)
O
Outcome
Cumulative incidence of infective endocarditis (IE) based on the modified Duke criteria at 5 yearshard clinical
Main Result
Absolute Event Rate: 1.01% vs 1.58%
p-value: p=0.047
TAVR with a self-expanding device is associated with a lower cumulative risk of infective endocarditis at 5 years compared to SAVR, though mortality remains high once IE occurs.
Cite This Study
Lanz et al. (2021) conducted a meta-analysis in Aortic valve replacement (n=4,077). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Cumulative incidence of infective endocarditis at 5 years (p=0.047). Transcatheter aortic valve replacement had a lower 5-year cumulative incidence of infective endocarditis compared to surgical replacement (1.01% vs 1.58%; P=0.047).