Infective endocarditis after transcatheter aortic valve implantation - data from national registry

There is relatively little detailed information about patients with IE after TAVI from nationwide registries.

To evaluate the incidence of IE after TAVI, to analyse the characteristics of patients, infectious agents, type of IE and patients' outcomes.

A total of 9887 TAVIs were performed at 14 centres in the Czech Republic between 2010 and 2023. Rehospitalization for potential IE (according to ICD-10 diagnosis) were identified. A total of 129 patients were confirmed with IE (27× possible IE, 102× definite IE) with cumulative incidence of 1.3%. The TAVI prosthesis in patients with definite IE was affected in 71 patients (70%), IE on mitral valve was present in 22 patients, 7 patients had device IE and site of infection was not identified in 2 patients. The main infectious agents were Enterococcus faecalis (37 patients, 29%) and Staphylococcus aureus (28 patients, 21%). Streptococcus species were the causative agents of IE in 27 cases (21%). Time from TAVI to occurrence of IE did not differ among the four main microbiological groups. The in-hospital mortality rate of patients with confirmed IE was 27%.

The cumulative incidence of infective endocarditis after TAVI was 1.3% in the large nationwide registry, with an in-hospital mortality of 27%. Enterococcus species were the most common pathogens without differences in time distribution compared to other causative agents.