Prosthetic valve endocarditis after TAVI occurred at a first-year incidence of 3.1% (95% CI 1.4-4.8%), with increased risk linked to suboptimal valve deployment and vascular complications.
Observational (n=509)
No
What is the incidence and what are the risk factors for prosthetic valve endocarditis after transcatheter aortic valve implantation in high-risk patients with aortic stenosis?
TAVI-PVE occurs at an annualized rate of 2.1% and is strongly associated with procedural factors like suboptimal valve deployment and vascular complications.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an advancing mode of treatment for inoperable or high-risk patients with aortic stenosis. Prosthetic valve endocarditis (PVE) after TAVI is a serious complication, but only limited data exist on its incidence, outcome, and procedural risk factors. METHODS AND RESULTS: Observational single-center study of 509 consecutive patients treated with a transcatheter implanted self-expandable aortic valve prosthesis (Medtronic CoreValve). We identified 18 patients diagnosed with TAVI-PVE during a median follow-up period of 1.4 years (interquartile range, 0.5-2.5 years; longest follow-up was 6.3 years). TAVI-PVE was most frequent in the first year after implantation (first-year incidence, 3.1% confidence interval, 1.4%-4.8%); the overall annualized rate was 2.1% per patient-year (confidence interval, 1.2%-3.3%). Seventeen patients (94%) were treated conservatively and 1 with surgery. Four patients (22%) died from endocarditis or complications to treatment, 2 of those (11%) during initial hospitalization for PVE. An increased risk of TAVI-PVE was seen in patients with low implanted valve position (hazard ratio, 2.8 1.1-7.2), moderate or worse postprocedural paravalvular regurgitation (hazard ratio, 4.0 1.5-11), implantation of >1 prosthesis (hazard ratio, 5.2 1.5-18), and any vascular complication (hazard ratio, 3.8 1.5-9.8). CONCLUSIONS: TAVI-PVE occurred at a slightly higher rate than reported for surgically implanted valves. Conservative treatment was associated with an acceptable outcome. Suboptimal valve deployment and vascular complications were associated with an increased risk of TAVI-PVE.
Olsen et al. (Wed,) conducted a observational in aortic stenosis (n=509). Transcatheter aortic valve implantation (TAVI) was evaluated on First-year incidence of prosthetic valve endocarditis (TAVI-PVE) (95% CI 1.4-4.8). Prosthetic valve endocarditis after TAVI occurred at a first-year incidence of 3.1% (95% CI 1.4-4.8%), with increased risk linked to suboptimal valve deployment and vascular complications.
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