Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Vassili Panagides - , Université Laval (Author)
  • David del Val - , Université Laval (Author)
  • Mohamed Abdel-Wahab - , Leipzig University, Segeberger Clinics (Author)
  • Norman Mangner - , Department of Internal Medicine and Cardiology (at Dresden Heart Centre), Leipzig University, TUD Dresden University of Technology (Author)
  • Eric Durand - , Normandie Université (Author)
  • Nikolaj Ihlemann - , University of Copenhagen (Author)
  • Marina Urena - , Université Paris Cité (Author)
  • Costanza Pellegrini - , Technical University of Munich (Author)
  • Francesco Giannini - , Vita-Salute San Raffaele University, Maria Cecilia Hospital (Author)
  • Tomasz Gasior - , TUD Dresden University of Technology (Author)
  • Wojtek Wojakowski - , Medical University of Silesia in Katowice (Author)
  • Martin Landt - , Segeberger Clinics (Author)
  • Vincent Auffret - , Université de Rennes 1 (Author)
  • Jan Malte Sinning - , Heart Center Bonn (Author)
  • Asim N. Cheema - , University of Toronto, Southlake Regional Health Centre (Author)
  • Luis Nombela-Franco - , Hospital Clinico Universitario San Carlos (Author)
  • Chekrallah Chamandi - , Hopital Europeen Georges-Pompidou (Author)
  • Francisco Campelo-Parada - , Rangueil University Hospital (Author)
  • Erika Munoz-Garcia - , Hospital Universitari Virgen de la Victoria (Author)
  • Howard C. Herrmann - , University of Pennsylvania (Author)
  • Luca Testa - , Gruppo San Donato (Author)
  • Won Keun Kim - , Kerckhoff Clinic (Author)
  • Juan Carlos Castillo - , Hospital Universitario Reina Sofía (Author)
  • Alberto Alperi - , Hospital Universitario Central de Asturias (Author)
  • Didier Tchetche - , Clinique Pasteur Toulouse (Author)
  • Antonio L. Bartorelli - , University of Milan (Author)
  • Samir Kapadia - , Cleveland Clinic Foundation (Author)
  • Stefan Stortecky - , University of Bern (Author)
  • Ignacio Amat-Santos - , Hospital Clínico Universitario de Valladolid (Author)
  • Harindra C. Wijeysundera - , University of Toronto (Author)
  • John Lisko - , Emory University (Author)
  • Enrique Gutiérrez-Ibanes - , Hospital General Universitario Gregorio Marañon (Author)
  • Vicenç Serra - , Autonomous University of Barcelona (Author)
  • Luisa Salido - , Hospital Ramon y Cajal (Author)
  • Abdullah Alkhodair - , University of British Columbia (Author)
  • Ugolino Livi - , University of Udine (Author)
  • Tarun Chakravarty - , Cedars-Sinai Medical Center (Author)
  • Stamatios Lerakis - , Emory University, Icahn School of Medicine at Mount Sinai (Author)
  • Victoria Vilalta - , Generalitat de Catalunya (Author)
  • Ander Regueiro - , Hospital Clinic of Barcelona (Author)
  • Rafael Romaguera - , University Hospital of Bellvitge (Author)
  • Marco Barbanti - , University of Catania (Author)
  • Utz Kappert - , University Medicine (Faculty of Medicine and University Hospital), Department of Cardiac Surgery (at Dresden Heart Centre), TUD Dresden University of Technology (Author)
  • Jean Bernard Masson - , University of Montreal (Author)
  • Frédéric Maes - , Université catholique de Louvain (Author)
  • Claudia Fiorina - , Brescia Civil Hospital (Author)
  • Antonio Miceli - , Istituto Clinico Sant'Ambrogio, University of Galway (Author)
  • Susheel Kodali - , Columbia University (Author)
  • Henrique B. Ribeiro - , Universidade de São Paulo, Hospital Samaritano (Author)
  • Jose Armando Mangione - , Royal and Beneficent Portuguese Charitable Association (Author)
  • Fabio Sandoli De Brito - , Universidade de São Paulo (Author)
  • Guglielmo Mario Actis Dato - , Ospedale Mauriziano Umberto I (Author)
  • Francesco Rosato - , Santa Croce and Carle Hospital Trust of Cuneo (Author)
  • Maria Cristina Ferreira - , Hospital Naval Marcilio Dias (Author)
  • Valter Correia de Lima - , Hospital São Francisco (Author)
  • Alexandre Siciliano Colafranceschi - , Hospital Pró-Cardíaco (Author)
  • Alexandre Abizaid - , Universidade de São Paulo (Author)
  • Marcos Antonio Marino - , Hospital Madre Teresa (Author)
  • Vinicius Esteves - , Hospital Sao Luis Itaim (Author)
  • Julio Andrea - , St. Vincent Clinic (Author)
  • Roger R. Godinho - , Hospital Samaritano (Author)
  • Fernando Alfonso - , Hospital Universitario de la Princesa (Author)
  • Helene Eltchaninoff - , Normandie Université (Author)
  • Lars Søndergaard - , University of Copenhagen (Author)
  • Dominique Himbert - , Université Paris Cité (Author)
  • Oliver Husser - , Technical University of Munich, St. Johannes Municipal Hospital (Author)
  • Azeem Latib - , Vita-Salute San Raffaele University, Montefiore Health System (Author)
  • Hervé Le Breton - , Université de Rennes 1 (Author)
  • Clement Servoz - , Rangueil University Hospital (Author)
  • Isaac Pascual - , Hospital Universitario Central de Asturias (Author)
  • Saif Siddiqui - , Clinique Pasteur Toulouse (Author)
  • Paolo Olivares - , University of Milan (Author)
  • Rosana Hernandez-Antolin - , Hospital Ramon y Cajal (Author)
  • John G. Webb - , University of British Columbia (Author)
  • Sandro Sponga - , University of Udine (Author)
  • Raj Makkar - , Cedars-Sinai Medical Center (Author)
  • Annapoorna S. Kini - , Icahn School of Medicine at Mount Sinai (Author)
  • Marouane Boukhris - , University of Montreal (Author)
  • Philippe Gervais - , Université Laval (Author)
  • Axel Linke - , Department of Internal Medicine and Cardiology (at Dresden Heart Centre), Leipzig University, TUD Dresden University of Technology (Author)
  • Lisa Crusius - , Leipzig University, TUD Dresden University of Technology (Author)
  • David Holzhey - , Leipzig University (Author)
  • Josep Rodés-Cabau - , Université Laval, Hospital Clinic of Barcelona (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 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. 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 (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27–3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57–4.69; P < .001) were 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 < .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 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). Conclusions. 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 high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.

Details

Original languageEnglish
Pages (from-to)638-646
Number of pages9
JournalClinical infectious diseases
Volume75
Issue number4
Publication statusPublished - 15 Aug 2022
Peer-reviewedYes

External IDs

PubMed 34894124

Keywords

Sustainable Development Goals

Keywords

  • heart surgery, infective endocarditis, TAVI, TAVR