Stefan Stortecky1, Dik Heg2, David Tueller3, Thomas Pilgrim1, Olivier Muller4, Stephane Noble5, Raban Jeger6, Stefan Toggweiler7, Enrico Ferrari8, Maurizio Taramasso9, Francesco Maisano9, Rebeca Hoeller1, Peter Wenaweser10, Fabian Nietlispach11, Andreas Widmer12, Christoph Huber5, Marco Roffi5, Thierry Carrel1, Stephan Windecker13, Anna Conen14. 1. Department of Cardiology and Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 2. Department of Clinical Research, Clinical Trials Unit and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. 3. Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland. 4. Department of Cardiology, Lausanne University Hospital-CHUV, Lausanne, Switzerland. 5. Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland. 6. Department of Cardiology, Basel University Hospital, University of Basel, Basel, Switzerland. 7. Cantonal Hospital Lucerne, Lucerne, Switzerland. 8. Department of Cardiovascular Surgery, Cardiocentro Ticino, Lugano, Switzerland. 9. Department of Cardiovascular Surgery, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland. 10. Heart Clinic Hirslanden, Hirslanden Clinic Zurich, Zurich, Switzerland. 11. Cardiovascular Center Zurich, Hirslanden Klinik Im Park, Zurich, Switzerland. 12. Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland. 13. Department of Cardiology and Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: stephan.windecker@insel.ch. 14. Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Aarau, Switzerland.
Abstract
BACKGROUND: Infective endocarditis may affect patients after transcatheter aortic valve replacement (TAVR). OBJECTIVES: The purpose of this study was to provide detailed information on incidence rates, types of microorganisms, and outcomes of infective endocarditis after TAVR. METHODS: Between February 2011 and July 2018, consecutive patients from the SwissTAVI Registry were eligible. Infective endocarditis was classified into early (peri-procedural [<100 days] and delayed-early [100 days to 1 year]) and late (>1 year) endocarditis. Clinical events were adjudicated according to the Valve Academic Research Consortium-2 endpoint definitions. RESULTS: During the observational period, 7,203 patients underwent TAVR at 15 hospitals in Switzerland. During follow-up of 14,832 patient-years, endocarditis occurred in 149 patients. The incidence for peri-procedural, delayed-early, and late endocarditis after TAVR was 2.59, 0.71, and 0.40 events per 100 person-years, respectively. Among patients with early endocarditis, Enterococcus species were the most frequently isolated microorganisms (30.1%). Among those with peri-procedural endocarditis, 47.9% of patients had a pathogen that was not susceptible to the peri-procedural antibiotic prophylaxis. Younger age (subhazard ratio [SHR]: 0.969; 95% confidence interval [CI]: 0.944 to 0.994), male sex (SHR: 1.989; 95% CI: 1.403 to 2.818), lack of pre-dilatation (SHR: 1.485; 95% CI: 1.065 to 2.069), and treatment in a catheterization laboratory as opposed to hybrid operating room (SHR: 1.648; 95% CI: 1.187 to 2.287) were independently associated with endocarditis. In a case-control matched analysis, patients with endocarditis were at increased risk of mortality (hazard ratio: 6.55; 95% CI: 4.44 to 9.67) and stroke (hazard ratio: 4.03; 95% CI: 1.54 to 10.52). CONCLUSIONS: Infective endocarditis after TAVR most frequently occurs during the early period, is commonly caused by Enterococcus species, and results in considerable risks of mortality and stroke. (NCT01368250).
BACKGROUND:Infective endocarditis may affect patients after transcatheter aortic valve replacement (TAVR). OBJECTIVES: The purpose of this study was to provide detailed information on incidence rates, types of microorganisms, and outcomes of infective endocarditis after TAVR. METHODS: Between February 2011 and July 2018, consecutive patients from the SwissTAVI Registry were eligible. Infective endocarditis was classified into early (peri-procedural [<100 days] and delayed-early [100 days to 1 year]) and late (>1 year) endocarditis. Clinical events were adjudicated according to the Valve Academic Research Consortium-2 endpoint definitions. RESULTS: During the observational period, 7,203 patients underwent TAVR at 15 hospitals in Switzerland. During follow-up of 14,832 patient-years, endocarditis occurred in 149 patients. The incidence for peri-procedural, delayed-early, and late endocarditis after TAVR was 2.59, 0.71, and 0.40 events per 100 person-years, respectively. Among patients with early endocarditis, Enterococcus species were the most frequently isolated microorganisms (30.1%). Among those with peri-procedural endocarditis, 47.9% of patients had a pathogen that was not susceptible to the peri-procedural antibiotic prophylaxis. Younger age (subhazard ratio [SHR]: 0.969; 95% confidence interval [CI]: 0.944 to 0.994), male sex (SHR: 1.989; 95% CI: 1.403 to 2.818), lack of pre-dilatation (SHR: 1.485; 95% CI: 1.065 to 2.069), and treatment in a catheterization laboratory as opposed to hybrid operating room (SHR: 1.648; 95% CI: 1.187 to 2.287) were independently associated with endocarditis. In a case-control matched analysis, patients with endocarditis were at increased risk of mortality (hazard ratio: 6.55; 95% CI: 4.44 to 9.67) and stroke (hazard ratio: 4.03; 95% CI: 1.54 to 10.52). CONCLUSIONS:Infective endocarditis after TAVR most frequently occurs during the early period, is commonly caused by Enterococcus species, and results in considerable risks of mortality and stroke. (NCT01368250).
Authors: Julia Grapsa; Christopher Blauth; Y S Chandrashekhar; Bernard Prendergast; Blair Erb; Michael Mack; Valentin Fuster Journal: JACC Case Rep Date: 2021-11-15
Authors: Vassili Panagides; Mohamed Abdel-Wahab; Norman Mangner; Eric Durand; Nikolaj Ihlemann; Marina Urena; Costanza Pellegrini; Francesco Giannini; Piotr Scislo; Zenon Huczek; Martin Landt; Vincent Auffret; Jan Malte Sinning; Asim N Cheema; Luis Nombela-Franco; Chekrallah Chamandi; Francisco Campelo-Parada; Erika Munoz-Garcia; Howard C Herrmann; Luca Testa; Won-Keun Kim; Helene Eltchaninoff; Lars Søndergaard; Dominique Himbert; Oliver Husser; Azeem Latib; Hervé Le Breton; Clement Servoz; Philippe Gervais; David Del Val; Axel Linke; Lisa Crusius; Holger Thiele; David Holzhey; Josep Rodés-Cabau Journal: Clin Res Cardiol Date: 2022-03-09 Impact factor: 6.138
Authors: Anthony J Buckley; Richard Tanner; Brian Armstrong; Saber Hassan; Barbara Moran; Jamie Byrne; Susan Groarke; Ronan Margey; Ivan P Casserly Journal: Ir J Med Sci Date: 2022-05-03 Impact factor: 2.089
Authors: Matthias Schindler; Florin Stöckli; Rico Brütsch; Philipp Jakob; Erik Holy; Jonathan Michel; Robert Manka; Paul Vogt; Christian Templin; Markus Kasel; Frank Ruschitzka; Barbara E Stähli Journal: J Am Heart Assoc Date: 2021-10-29 Impact factor: 5.501
Authors: Taishi Okuno; Caglayan Demirel; Daijiro Tomii; Gabor Erdoes; Dik Heg; Jonas Lanz; Fabien Praz; Rainer Zbinden; David Reineke; Lorenz Räber; Stefan Stortecky; Stephan Windecker; Thomas Pilgrim Journal: JAMA Netw Open Date: 2022-07-01
Authors: Jonas Lanz; Michael J Reardon; Thomas Pilgrim; Stefan Stortecky; G Michael Deeb; Stanley Chetcuti; Steven J Yakubov; Thomas G Gleason; Jian Huang; Stephan Windecker Journal: J Am Heart Assoc Date: 2021-09-28 Impact factor: 5.501