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Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

283
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
283
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

141
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
141
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

261
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
261
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

223
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
223
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

309
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
309
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

170
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
170

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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Infective Endocarditis After Transcatheter Aortic Valve Replacement.

Stefan Stortecky1, Dik Heg2, David Tueller3

  • 1Department of Cardiology and Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Journal of the American College of Cardiology
|June 20, 2020
PubMed
Summary

Infective endocarditis after transcatheter aortic valve replacement (TAVR) most often occurs early and is frequently caused by Enterococcus species. This condition significantly increases the risk of mortality and stroke in patients.

Keywords:
TAVRendocarditisoutcomes

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Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Infective endocarditis (IE) is a potential complication following transcatheter aortic valve replacement (TAVR).
  • Understanding the epidemiology and outcomes of IE post-TAVR is crucial for patient management.

Purpose of the Study:

  • To determine the incidence rates of infective endocarditis after TAVR.
  • To identify the common microorganisms responsible for IE post-TAVR.
  • To analyze the clinical outcomes and risk factors associated with IE following TAVR.

Main Methods:

  • A retrospective analysis of 7,203 patients who underwent TAVR between 2011 and 2018 from the SwissTAVI Registry.
  • Infective endocarditis cases were classified as early (peri-procedural or delayed-early) or late.
  • Clinical events were adjudicated using Valve Academic Research Consortium-2 criteria; risk factors and outcomes were analyzed.

Main Results:

  • The incidence of IE was highest in the peri-procedural period (2.59/100 person-years), decreasing over time.
  • Enterococcus species were the most common pathogens in early IE (30.1%).
  • Independent risk factors for IE included younger age, male sex, lack of pre-dilatation, and catheterization lab procedures; IE significantly increased mortality (HR 6.55) and stroke risk (HR 4.03).

Conclusions:

  • Infective endocarditis post-TAVR predominantly occurs early, often involves Enterococcus species, and is associated with substantial risks of mortality and stroke.
  • Findings highlight the need for vigilance and potentially tailored prophylactic strategies for high-risk TAVR patients.