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Infective Endocarditis Following Aortic Valve Replacement: A Systematic Review
Ethan Slouha1, Catherine Rood2, Venkata Sathya Burle1
1Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD.
Cureus
|December 20, 2023
Summary
Aortic valve replacement (AVR), including surgical (SAVR) and transcatheter (TAVR) approaches, can lead to infective endocarditis (IE). Research is ongoing to determine if IE rates differ between SAVR and TAVR procedures.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Innovation
Background:
- Aortic valve replacement (AVR) treats aortic stenosis and regurgitation, restoring left ventricular outflow tract (LVOT) function.
- AVR is performed surgically (SAVR) or via transcatheter (TAVR) minimally invasive procedures.
- Infective endocarditis (IE) is a rare but serious complication of AVR, increasing mortality and hindering recovery.
Purpose of the Study:
- To evaluate and compare the incidence and characteristics of IE following SAVR versus TAVR.
- To identify potential differences in causative microorganisms and risk factors between SAVR- and TAVR-associated IE.
- To elucidate risks associated with AVR procedures despite their rarity.
Main Methods:
- Review of existing studies comparing IE rates and outcomes after SAVR and TAVR.
- Analysis of reported causative agents and patient risk factors for IE in both procedural groups.
- Synthesis of current evidence to determine trends or differences in IE incidence.
Main Results:
- Studies remain inconclusive regarding a definitive difference in IE incident rates between SAVR and TAVR.
- SAVR-associated IE is often linked to *Staphylococcus aureus*, while TAVR-associated IE may involve *Enterococcus spp.*.
- Both procedures share common risk factors for IE, and overall incidence rates are considered higher than expected.
Conclusions:
- Further research is needed to clarify IE incidence differences between SAVR and TAVR.
- Identifying specific pathways and risk factors is crucial for reducing the occurrence of AVR-associated IE.
- Understanding IE in the context of AVR is vital for improving patient outcomes and procedural safety.
