Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation.
(2022) The American Journal of Cardiology — Vol. 172, n° 1, p. 90-97 (2022)
Files
Mitralvalveinfectiveendocarditisaftertrans-catheter.pdf
Open Access - Adobe PDF
- 510.33 KB
Details
- Authors
- Abstract
- Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation ≥2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p <0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p <0.001) and septic shock (adjusted p <0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation ≥2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up.
- Affiliations
Citations
Panagides, V., Del Val, D., Abdel-Wahab, M., Mangner, N., Durand, E., Ihlemann, N., Urena, M., Pellegrini, C., Giannini, F., Scislo, P., Huczek, Z., Landt, M., Auffret, V., Sinning, J. M., Cheema, A. N., Nombela-Franco, L., Chamandi, C., Campelo-Parada, F., Munoz-Garcia, E., et al. (2022). Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation. The American Journal of Cardiology, 172(1), 90-97. https://doi.org/10.1016/j.amjcard.2022.02.034 (Original work published 2022)