Infective Endocarditis Following Transcatheter Aortic Valve Replacement: Comparison of Balloon- Versus...

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Limited data exist on infective endocarditis (IE) characteristics following transcatheter aortic valve replacement (TAVR) based on prosthetic valve type.
• IE is a serious complication after TAVR, necessitating a deeper understanding of its presentation and outcomes.

Purpose of the Study:

• To compare the incidence, clinical features, and outcomes of IE post-TAVR between patients who received balloon-expandable valves (BEV) and self-expanding valves (SEV).

Main Methods:

• Utilized data from the multicenter Infectious Endocarditis After TAVR International Registry.
• Compared IE patients who received BEV versus SEV, analyzing timing, causative microorganisms, vegetation location, embolic events, and mortality.

Main Results:

• Enterococcal IE was more prevalent in the SEV group (36.5%) compared to the BEV group (15.4%).
• Vegetation location differed, with more stent frame involvement in SEV (18.6%) and valve leaflet involvement in BEV (38.5%).
• BEV recipients showed a higher incidence of stroke/systemic embolism (20.0% vs. 8.7%), while surgical explant and in-hospital mortality rates were similar between groups.

Conclusions:

• Infective endocarditis characteristics post-TAVR vary by valve type, particularly regarding causative agents and vegetation sites.
• Embolic complications, such as stroke, were more frequent in BEV recipients.
• Despite differing characteristics, early and late mortality did not significantly differ between BEV and SEV groups, suggesting valve type influences IE presentation but not overall survival.