Related Experiment Video
Updated: Sep 12, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Infective endocarditis and cardiac events after transcatheter vs surgical aortic valve replacement: A nationwide
Alexander Kutz1, Martin Purtak2, Rahel Laager3
1Department of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland; Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; Medical Faculty, University of Basel, Basel, Switzerland.
Objectives:
To compare rates of infective endocarditis (IE) and major adverse cardiac events (MACE) in patients with TAVI, bioprosthetic (bio), and mechanical (mech) SAVR.
Methods:
Population-based cohort study of inpatient adults undergoing TAVI, bioSAVR or mechSAVR for aortic valve stenosis between 2012 and 2021 in Switzerland. In 2 pairwise 1:1 propensity-score matched cohorts (TAVI versus bioSAVR and bioSAVR versus mechSAVR) we analysed the primary outcome of the incidence of IE and secondary outcomes including MACE.
Results:
Among 18,253 patients undergoing aortic valve replacement (mean age 76.6±10.3 years, 43.8% female), the incidence rate (IR) of IE was highest in the first 3 months after the intervention (TAVI, bioSAVR, mechSAVR: 23.61, 18.87, 16.65 per 1000 person-years, respectively). After matching, the rate of IE was higher in patients undergoing TAVI versus bioSAVR (n=2329 pairs, HR 1.56 [95% CI, 1.12-2.18]; incidence rate difference [IRD] 3.84 [95% CI,1.29-6.39] per 1000 person-years), and higher in bioSAVR versus mechSAVR (n=773, HR 2.27 [1.24-4.15]; IRD 4.57 [1.29-7.85] per 1000 person-years). The HRs for MACE were 2.10 [1.90-2.33] and 2.09 [1.58-2.77], respectively.
Conclusions:
For patients undergoing aortic valve replacement for native aortic valve stenosis, TAVI was associated with higher rates of IE than bioSAVR, as was bioSAVR when compared with mechSAVR.
Related Concept Videos
Endocarditis I: Introduction
Endocarditis III: Medical Management
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation I: Introduction
Aortic Regurgitation III: Medical Management
Aneurysm III: Interprofessional Care

