Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation - PubMed (original) (raw)

Multicenter Study

doi: 10.1016/j.amjcard.2022.02.034. Epub 2022 Apr 3.

David Del Val 1, Mohamed Abdel-Wahab 2, Norman Mangner 3, Eric Durand 4, Nikolaj Ihlemann 5, Marina Urena 6, Costanza Pellegrini 7, Francesco Giannini 8, Piotr Scislo 9, Zenon Huczek 9, Martin Landt 10, Vincent Auffret 11, Jan Malte Sinning 12, Asim N Cheema 13, Luis Nombela-Franco 14, Chekrallah Chamandi 15, Francisco Campelo-Parada 16, Erika Munoz-Garcia 17, Howard C Herrmann 18, Luca Testa 19, Won-Keun Kim 20, Juan Carlos Castillo 21, Alberto Alperi 22, Didier Tchetche 23, Antonio L Bartorelli [ 24](#full-view-affiliation-24 "Centro Cardiologico Monzino, IRCCS and Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy."), Samir Kapadia 25, Stefan Stortecky 26, Ignacio Amat-Santos 27, Harindra C Wijeysundera 28, John Lisko 29, Enrique Gutiérrez-Ibanes 30, Vicenç Serra 31, Luisa Salido 32, Abdullah Alkhodair 33, Ugolino Livi 34, Tarun Chakravarty 35, Stamatios Lerakis 36, Victoria Vilalta 37, Ander Regueiro 38, Rafael Romaguera 39, Utz Kappert 40, Marco Barbanti 41, Jean-Bernard Masson 42, Frédéric Maes 43, Claudia Fiorina 44, Antonio Miceli 45, Susheel Kodali 46, Henrique B Ribeiro 47, Jose Armando Mangione 48, Fabio Sandoli de Brito Jr 49, Guglielmo Mario Actis Dato 50, Francesco Rosato 51, Maria-Cristina Ferreira 52, Valter Correia de Lima 53, Alexandre Siciliano Colafranceschi 54, Alexandre Abizaid 49, Marcos Antonio Marino 55, Vinicius Esteves 56, Julio Andrea 57, Roger R Godinho 58, Fernando Alfonso 59, Helene Eltchaninoff 4, Lars Søndergaard 5, Dominique Himbert 6, Oliver Husser 60, Azeem Latib 61, Hervé Le Breton 11, Clement Servoz 16, Isaac Pascual 22, Saif Siddiqui 23, Paolo Olivares [ 24](#full-view-affiliation-24 "Centro Cardiologico Monzino, IRCCS and Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy."), Rosana Hernandez-Antolin 32, John G Webb 33, Sandro Sponga 34, Raj Makkar 35, Annapoorna S Kini 62, Marouane Boukhris 42, Philippe Gervais 1, Axel Linke 3, Lisa Crusius 3, David Holzhey 63, Josep Rodés-Cabau 64

Affiliations

Multicenter Study

Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation

Vassili Panagides et al. Am J Cardiol. 2022.

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.

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