Infectious endocarditis on percutaneous aortic valve prosthesis: comparison with surgical bioprostheses

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Infective endocarditis (IE) is a serious complication following aortic valve replacement procedures.
• Transcatheter aortic valve implantation (TAVI) is increasingly used, even in lower-risk patients, potentially increasing IE incidence.
• Comparative data on IE incidence and outcomes between TAVI and surgical aortic valve replacement (SAVR) are crucial.

Purpose of the Study:

• To compare the incidence and mortality rates of IE in patients who underwent TAVI versus SAVR.
• To analyze clinical features and management strategies for IE in both TAVI and SAVR cohorts.

Main Methods:

• Retrospective, single-center cohort study of IE cases diagnosed between 2008 and 2022.
• Inclusion of patients who underwent either TAVI or SAVR for aortic valve stenosis.
• Comparison of IE incidence, clinical characteristics, treatment, and mortality between the TAVI and SAVR groups.

Main Results:

• The incidence of IE was 0.09/100 patient-years for TAVI and 0.12/100 patient-years for SAVR (P = .64).
• Clinical features were similar, with comparable rates of cardiac complications and surgical indications for IE.
• One-year mortality rates for IE were not significantly different between TAVI (30%) and SAVR (29%) groups (P = .56).

Conclusions:

• The incidence of IE following TAVI is low.
• Despite a potentially worse clinical profile, TAVI patients with IE did not experience significantly higher mortality compared to SAVR patients.
• These findings support the safety profile of TAVI concerning IE complications.