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Updated: Oct 10, 2025
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
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Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement
Vassili Panagides1, David Del Val1, Mohamed Abdel-Wahab2,3
1Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
Summary
Perivalvular extension (PEE) complicates infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR), increasing mortality risk. Chronic kidney disease and specific bacteria heighten PEE risk, while surgery may improve outcomes in these high-risk IE patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) is associated with poor prognosis.
- Data on IE perivalvular extension (PEE) in TAVR patients are limited.
Purpose of the Study:
- To investigate the incidence, risk factors, and outcomes of PEE in patients with IE post-TAVR.
Main Methods:
- Multicenter study of 579 patients diagnosed with definite IE after TAVR.
- PEE defined as intracardiac abscess, pseudoaneurysm, or fistula.
- Analysis of risk factors for PEE and associated mortality.
Main Results:
- PEE occurred in 18.1% of patients.
- Chronic kidney disease and coagulase-negative staphylococci IE increased PEE risk.
- PEE patients had higher rates of surgery and significantly increased in-hospital (36.5%) and 2-year (69.4%) mortality.
Conclusions:
- PEE is a significant complication of IE post-TAVR, associated with high mortality.
- Risk factors include chronic kidney disease and specific bacterial pathogens.
- Surgery during the index IE hospitalization may be associated with improved outcomes.
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