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Multicenter Study of Endocarditis After Transcatheter Pulmonary Valve Replacement
Doff B McElhinney1, Yulin Zhang1, Jamil A Aboulhosn2
1Stanford University School of Medicine, Palo Alto, California, USA.
Journal of the American College of Cardiology
|August 6, 2021
Summary
Endocarditis is a significant risk after transcatheter pulmonary valve replacement (TPVR), with younger age, prior infection, and higher residual gradient as key risk factors. This study highlights the importance of monitoring for this complication in RVOT dysfunction management.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Infectious Diseases
Background:
- Endocarditis is a major complication following transcatheter pulmonary valve replacement (TPVR).
- Limited data exists on risk factors and outcomes of endocarditis post-TPVR.
Purpose of the Study:
- To evaluate risk factors and outcomes of endocarditis in a large, international multicenter cohort of TPVR patients.
Main Methods:
- Established an international registry to collect data on endocarditis after TPVR.
- Analyzed data from 2,476 patients undergoing TPVR between July 2005 and March 2020.
- Assessed incidence, risk factors, characteristics, and outcomes of endocarditis.
Main Results:
- 182 patients (7.4%) developed endocarditis, with a cumulative incidence of 16.9% at 8 years.
- Risk factors included younger age, prior endocarditis, and higher residual gradient; valve type was not significant.
- Staphylococcus aureus and Viridans group Streptococcus were common pathogens; endocarditis led to severe outcomes in 44% and death in 6.6%.
Conclusions:
- Endocarditis incidence post-TPVR is constant over time and consistent with previous studies.
- Findings are crucial for improving lifetime management of patients with right ventricular outflow tract (RVOT) disease.
- TPVR remains vital for RVOT dysfunction despite endocarditis risks.
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