Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve Replacement
Vassili Panagides, Guillermo Cuervo, Jaume Llopis, Mohamed Abdel‐Wahab, Norman Mangner, Gilbert Habib, Ander Regueiro, Carlos A. Mestres, Pilar Tornos, Éric Durand, Christine Selton‐Suty, Nikolaj Ihlemann, Niels Eske Bruun, Marina Ureña, Enrico Cecchi, Hölger Thiele, Emanuele Durante‐Mangoni, Costanza Pellegrini, Hélène Eltchaninoff, Eugene Athan, Lars Søndergaard, Axel Linke, Pierre Tattevin, David del Val, Eduard Quintana, Vivian H. Chu, Josep Rodés‐Cabau, José M. Miró, TAVI Infective Endocarditis International Registry and ICE Investigators, Liliana Clara, Marisa Sánchez, José Casabé, Claudia Cortés, Francisco Nacinovich, P. Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Javier Altclas, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Lito E. Papanicolas, Tony M. Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Koneçny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Phillip Jones, Suzanne Ryan, Phillip Jones, Suzanne Ryan, Phillip Jones, Jeffrey J. Post, Porl Reinbott, Suzanne Ryan, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armênio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Rinaldo Focaccia Siciliano, Tânia Mara Varejão Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Cláudio Querido Fortes, Auristela de Oliveira Ramos, Clara Weksler, G. Ferraiuoli, W. Golebiovski, Cristiane da Cruz Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Muñoz García, Mauricio Cereceda, Alberto Fíca, Rodrigo Montagna Mella, Ricardo Fernández, Liliana Franco, Javier González, Astrid Natalia Jaramillo, Bruno Baršić, Suzana Bukovski, Vladimir Krajinović, Ana Pangerčić
Abstract
BACKGROUND: Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR. METHODS: Data were collected from the "Infectious Endocarditis after TAVR International" (enrollment from 2005 to 2020) and the "International Collaboration on Endocarditis" (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR. RESULTS: A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P < .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P < .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P < .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P < .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697). CONCLUSIONS: Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up.