Perivalvular Extension of Infective Endocarditis after Transcatheter Aortic Valve Replacement - Archive ouverte HAL Access content directly
Journal Articles Clinical Infectious Diseases Year : 2021

Perivalvular Extension of Infective Endocarditis after Transcatheter Aortic Valve Replacement

(1) , (1) , (2) , (2) , (3) , , (4) , , , , , , (5, 6) , , , , (7) , (8) , , , , , , , (9) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , (10, 11) , (11) , (1)
1
2
3
4
5
6
7
8
9
10
11
Vassili Panagides
Mohamed Abdel-Wahab
Nikolaj Ihlemann
  • Function : Author
Costanza Pellegrini
  • Function : Author
Francesco Giannini
Tomasz Gasior
  • Function : Author
Wojtek Wojakowski
  • Function : Author
Martin Landt
  • Function : Author
Jan Malte Sinning
  • Function : Author
Asim Cheema
  • Function : Author
Luis Nombela-Franco
Francisco Campelo-Parada
Erika Munoz-Garcia
  • Function : Author
Howard Herrmann
  • Function : Author
Luca Testa
Kim Won-Keun
  • Function : Author
Juan Carlos Castillo
  • Function : Author
Alberto Alperi
Antonio Bartorelli
  • Function : Author
Samir Kapadia
Stefan Stortecky
  • Function : Author
Ignacio Amat-Santos
  • Function : Author
Harindra Wijeysundera
  • Function : Author
John Lisko
  • Function : Author
Enrique Gutiérrez-Ibanes
  • Function : Author
Vicenç Serra
  • Function : Author
Luisa Salido
Abdullah Alkhodair
  • Function : Author
Ugolino Livi
  • Function : Author
Tarun Chakravarty
  • Function : Author
Stamatios Lerakis
  • Function : Author
Victoria Vilalta
  • Function : Author
Ander Regueiro
  • Function : Author
Rafael Romaguera
Utz Kappert
Marco Barbanti
Jean-Bernard Masson
  • Function : Author
Frédéric Maes
  • Function : Author
Claudia Fiorina
  • Function : Author
Antonio Miceli
Susheel Kodali
  • Function : Author
Henrique Ribeiro
  • Function : Author
Jose Armando Mangione
  • Function : Author
Fabio Sandoli de Brito Jr
  • Function : Author
Guglielmo Mario Actis Dato
  • Function : Author
Francesco Rosato
  • Function : Author
Maria-Cristina Ferreira
  • Function : Author
Valter Correia de Lima
  • Function : Author
Alexandre Abizaid
  • Function : Author
Marcos Antonio Marino
  • Function : Author
Vinicius Esteves
  • Function : Author
Julio Andrea
  • Function : Author
Roger Godinho
  • Function : Author
Fernando Alfonso
  • Function : Author
Helene Eltchaninoff
  • Function : Author
Lars Søndergaard
  • Function : Author
Dominique Himbert
  • Function : Author
Oliver Husser
  • Function : Author
Azeem Latib
Hervé Le Breton
  • Function : Author
Clement Servoz
  • Function : Author
Isaac Pascual
Saif Siddiqui
  • Function : Author
Paolo Olivares
  • Function : Author
Rosana Hernandez-Antolin
  • Function : Author
John Webb
  • Function : Author
Sandro Sponga
  • Function : Author
Raj Makkar
Annapoorna Kini
  • Function : Author
Marouane Boukhris
  • Function : Author
Philippe Gervais
  • Function : Author
Axel Linke
  • Function : Author
David Holzhey
  • Function : Author

Abstract

Background: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients.Methods: This multicenter study included a total of 579 patients who had the diagnosis of definite IE at a median of 171 (53-421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm or fistula confirmed by transthoracic/transophageal echocardiography, computed tomography or peri-operative findings.Results: A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (ORadj: 2.08; 95% CI: [1.27-3.41], p=0.003) and IE secondary to coagulase-negative staphylococci (ORadj: 2.71; 95% CI: [1.57-4.69], p<0.001) was associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs. 15.2% in patients without PEE, p<0.001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality risk were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj<0.05 for all).Conclusion: PEE occurred in about one fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited very high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.
Fichier principal
Vignette du fichier
Panagides et al-2021-Perivalvular Extension of Infective Endocarditis after Transcatheter Aortic.pdf (1.15 Mo) Télécharger le fichier
Origin : Files produced by the author(s)

Dates and versions

hal-03520845 , version 1 (26-01-2022)

Licence

Attribution - NonCommercial - CC BY 4.0

Identifiers

Cite

Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, et al.. Perivalvular Extension of Infective Endocarditis after Transcatheter Aortic Valve Replacement. Clinical Infectious Diseases, 2021, ⟨10.1093/cid/ciab1004⟩. ⟨hal-03520845⟩
64 View
102 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More