Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands

J. Brouwer*, F.S. van den Brink, V.J. Nijenhuis, T.N. Vossenberg, R. Delewi, M.S. van Mourik, P. den Heijer, W. Tanis, P.C. Kievit, W. Holvoet, R.S. Hermanides, J.M. ten Berg

*Corresponding author for this work

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Abstract

Background Transcatheter aortic valve replacement (TAVR) is increasingly being used as an alternative to conventional surgical valve replacement. Prosthetic valve endocarditis (PVE) is a rare but feared complication after TAVR, with reported first-year incidences varying from 0.57 to 3.1%. This study was performed to gain insight into the incidence and outcome of PVE after TAVR in the Netherlands. Methods A multicentre retrospective registry study was performed. All patients who underwent TAVR in the period 2010-2017 were screened for the diagnosis of infective endocarditis in the insurance database and checked for the presence of PVE before analysis of general characteristics, PVE parameters and outcome. Results A total of 3968 patients who underwent TAVR were screened for PVE. During a median follow-up of 33.5 months (interquartile range (IQR) 22.8-45.8), 16 patients suffered from PVE (0.4%), with a median time to onset of 177 days (IQR 67.8-721.3). First-year incidence was 0.24%, and the overall incidence rate was 0.14 events per 1000 person-years. Overall mortality during follow-up in our study was 31%, of which 25% occurred in hospital. All patients were treated conservatively with intravenous antibiotics alone, and none underwent a re-intervention. Other complications of PVE occurred in 5 patients (31%) and included aortic abscess (2), decompensated heart failure (2) and cerebral embolisation (1). Conclusion PVE in patients receiving TAVR is a relatively rare complication and has a high mortality rate.
Original languageEnglish
Pages (from-to)520-525
Number of pages6
JournalNetherlands Heart Journal
Volume28
Issue number10
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • Aortic valve stenosis
  • CRITERIA
  • DIAGNOSIS
  • IMPLANTATION
  • INFECTIVE ENDOCARDITIS
  • Prosthetic valve endocarditis
  • RISK
  • Structural heart intervention
  • Structural heart valve disease
  • Transcatheter aortic valve replacement
  • aortic valve stenosis
  • criteria
  • diagnosis
  • implantation
  • infective endocarditis
  • prosthetic valve endocarditis
  • risk
  • structural heart intervention
  • structural heart valve disease
  • transcatheter aortic valve replacement
  • ASSOCIATION

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