Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve Replacement
Authors: Panagides Vassili , Cuervo Guillermo , Llopis Jaume , Abdel-Wahab Mohamed , Mangner Norman , Habib Gilbert , Regueiro Ander , Mestres Carlos A , Tornos Pilar , Durand Eric , Selton-Suty Christine , Ihlemann Nikolaj , Bruun Niels , Urena Marina , Cecchi Enrico , Thiele Holger , Durante-Mangoni Emanuele , Pellegrini Costanza , Eltchaninoff Helene , Athan Eugene , Søndergaard Lars , Linke Axel , Tattevin Pierre , del Val David , Quintana Eduard , Chu Vivian , Rodés-Cabau Josep , Miro Jose M ,   TAVI Infective Endocarditis International Registry and ICE Investigators, Clara Liliana , Sanchez Marisa , Casabé José , Cortes Claudia , Nacinovich Francisco , Oses Pablo Fernandez , Ronderos Ricardo , Sucari Adriana , Thierer Jorge , Altclas Javier , Kogan Silvia , Spelman Denis , Athan Eugene , Harris Owen , Kennedy Karina , Tan Ren , Gordon David , Papanicolas Lito , Korman Tony , Kotsanas Despina , Dever Robyn , Jones Phillip , Konecny Pam , Lawrence Richard , Rees David , Ryan Suzanne , Feneley Michael P , Harkness John , Jones Phillip , Ryan Suzanne , Jones Phillip , Ryan Suzanne , Jones Phillip , Post Jeffrey , Reinbott Porl , Ryan Suzanne , Gattringer Rainer , Wiesbauer Franz , Andrade Adriana Ribas , de Brito Ana Cláudia Passos , Guimarães Armenio Costa , Grinberg Max , Mansur Alfredo José , Siciliano Rinaldo Focaccia , Strabelli Tania Mara Varejao , Vieira Marcelo Luiz Campos , de Medeiros Tranchesi Regina Aparecida , Paiva Marcelo Goulart , Fortes Claudio Querido , de Oliveira Ramos Auristela , Weksler Clara , Ferraiuoli Giovanna , Golebiovski Wilma , Lamas Cristiane , Karlowsky James A , Keynan Yoav , Morris Andrew M , Rubinstein Ethan , Jones Sandra Braun , Garcia Patricia , Cereceda M , Fica Alberto , Mella Rodrigo Montagna , Fernandez Ricardo , Franco Liliana , Gonzalez Javier , Jaramillo Astrid Natalia , Barsic Bruno , Bukovski Suzana , Krajinovic Vladimir , Pangercic Ana , Rudez Igor , Vincelj Josip , Freiberger Tomas , Pol Jiri , Zaloudikova Barbora , Ashour Zainab , El Kholy Amani , Mishaal Marwa , Osama Dina , Rizk Hussien , Aissa Neijla , Alauzet Corentine , Alla Francois , Campagnac Catherine , Doco-Lecompte Thanh , Selton-Suty Christine , Casalta Jean-Paul , Fournier Pierre-Edouard , Habib Gilbert , Raoult Didier , Thuny Franck , Delahaye Francois , Delahaye Armelle , Vandenesch Francois , Donal Erwan , Donnio Pierre Yves , Flecher Erwan , Michelet Christian , Revest Matthieu , Tattevin Pierre , Chevalier Florent , Jeu Antoine , Rémadi Jean Paul , Rusinaru Dan , Tribouilloy Christophe , Bernard Yvette , Chirouze Catherine , Hoen Bruno , Leroy Joel , Plesiat Patrick , Naber Christoph , Neuerburg Carl , Mazaheri Bahram , Naber Christoph , Neuerburg Carl , Athanasia Sophia , Deliolanis Ioannis , Giamarellou Helen , Thomas Tsaganos , Giannitsioti Efthymia , Mylona Elena , Paniara Olga , Papanicolaou Konstantinos , Pyros John , Skoutelis Athanasios , Mylona Elena , Paniara Olga , Papanikolaou Konstantinos , Pyros John , Skoutelis Athanasios , Sharma Gautam , Francis Johnson , Nair Lathi , Thomas Vinod , Venugopal Krishnan , Hannan Margaret M , Hurley John P , Wanounou Maor , Gilon Dan , Israel Sarah , Korem Maya , Strahilevitz Jacob , Rubinstein Ethan , Strahilevitz Jacob , Durante-Mangoni Emanuele , Iossa Domenico , Orlando Serena , Ursi Maria Paola , Pafundi Pia Clara , D’Amico Fabiana , Bernardo Mariano , Cuccurullo Susanna , Dialetto Giovanni , Covino Franco Enrico , Manduca Sabrina , Corte Alessandro Della , De Feo Marisa , Tripodi Marie Françoise , Cecchi Enrico , De Rosa Francesco , Forno Davide , Imazio Massimo , Trinchero Rita , Grossi Paolo , Lattanzio Mariangela , Toniolo Antonio , Goglio Antonio , Raglio Annibale , Ravasio Veronica , Rizzi Marco , Suter Fredy , Carosi Giampiero , Magri Silvia , Signorini Liana , Kanafani Zeina , Kanj Souha S , Sharif-Yakan Ahmad , Abidin Imran , Tamin Syahidah Syed , Martínez Eduardo Rivera , Nieto Gabriel Israel Soto , van der Meer Jan T M , Chambers Stephen , Holland David , Morris Arthur , Raymond Nigel , Read Kerry , Murdoch David R , Dragulescu Stefan , Ionac Adina , Mornos Cristian , Butkevich O M , Chipigina Natalia , Kirill Ozerecky , Vadim Kulichenko , Vinogradova Tatiana , Edathodu Jameela , Halim Magid , Liew Yee-Yun , Tan Ru-San , Lejko-Zupanc Tatjana , Logar Mateja , Mueller-Premru Manica , Commerford Patrick , Commerford Anita , Deetlefs Eduan , Hansa Cass , Ntsekhe Mpiko , Almela Manel , Ambrosioni Juan , Azqueta Manuel , Brunet Merce , Castro Pedro , De Lazzari Elisa , Falces Carlos , Fuster David , Fita Guillermina , Maria Cristina Garcia- de- la- , Garcia-Gonzalez Javier , Gatell Jose M , Llopis Jaume , Marco Francesc , Miró José M , Moreno Asuncion , Ortiz José , Ninot Salvador , Paré J Carlos , Pericas Juan M , Quintana Eduard , Ramirez Jose , Rovira Irene , Sandoval Elena , Sitges Marta , Tellez Adrian , Tolosana José M , Vidal Barbara , Vila Jordi , Anguera Ignasi , Font Bernat , Guma Joan Raimon , Bermejo Javier , Bouza Emilio , Fernández Miguel Angel Garcia , Gonzalez-Ramallo Victor , Marín Mercedes , Muñoz Patricia , Pedromingo Miguel , Roda Jorge , Rodríguez-Créixems Marta , Solis Jorge , Almirante Benito , Fernandez-Hidalgo Nuria , Tornos Pilar , de Alarcón Arístides , Parra Ricardo , Alestig Eric , Johansson Magnus , Olaison Lars , Snygg-Martin Ulrika , Pachirat Orathai , Pachirat Pimchitra , Pussadhamma Burabha , Senthong Vichai , Casey Anna , Elliott Tom , Lambert Peter , Watkin Richard , Eyton Christina , Klein John L , Bradley Suzanne , Kauffman Carol , Bedimo Roger , Chu Vivian H , Corey G Ralph , Crowley Anna Lisa , Douglas Pamela , Drew Laura , Fowler Vance G , Holland Thomas , Lalani Tahaniyat , Mudrick Daniel , Samad Zaniab , Sexton Daniel , Stryjewski Martin , Wang Andrew , Woods Christopher W , Lerakis Stamatios , Cantey Robert , Steed Lisa , Wray Dannah , Dickerman Stuart A , Bonilla Hector , DiPersio Joseph , Salstrom Sara-Jane , Baddley John , Patel Mukesh , Peterson Gail , Stancoven Amy , Levine Donald , Riddle Jonathan , Rybak Michael , Cabell Christopher H , Abdel-Wahab Mohamed , Abizaid Alexandre , Actis Dato GuglielmoMario , Alfonso Fernando , Alkhodair Abdullah , Alperi Alberto , Amat-Santos Ignacio , Andrea Julio , Auffret Vincent , Barbanti Marco , Bartorelli Antonio L , Boukhris Marouane , Campelo-Parada Francisco , Castillo Juan Carlos , Chakravarty Tarun , Chamandi Chekrallah , Cheema Asim N , Colafranceschi Alexandre Siciliano , Correia De Lima Valter , Crusius Lisa , Del Val David , Durand Eric , Eltchaninoff Helene , Esteves Vinicius , Ferreira Maria-Cristina , Fiorina Claudia , Gervais Philippe , Giannini Francesco , Godinho Roger R , Gutiérrez-Ibanes Enrique , Hernandez-Antolin Rosana , Herrmann Howard C , Himbert Dominique , Holzhey David , Huczek Zenon , Husser Oliver , Ihlemann Nikolaj , Kapadia Samir , Kappert Utz , Kim Won-Keun , Kini Annapoorna S , Kodali Susheel , Landt Martin , Latib Azeem , Le Breton Hervé , Linke Axel , Lisko John , Livi Ugolino , Maes Frédéric , Makkar Raj , Mangione Jose Armando , Mangner Norman , Marino Marcos Antonio , Masson Jean-Bernard , Miceli Antonio , Munoz-Garcia Erika , Nombela-Franco Luis , Olivares Paolo , Panagides Vassili , Pascual Isaac , Regueiro Ander , Ribeiro Henrique B , Rodés-Cabau Josep , Romaguera Rafael , Rosato Francesco , Salido Luisa , Sandoli De Brito Fabio , Scislo Piotr , Serra Vicenç , Servoz Clement , Siddiqui Saif , Sinning Jan Malte , Søndergaard Lars , Sponga Sandro , Stortecky Stefan , Tchetche Didier , Testa Luca , Urena Marina , Vilalta Victoria , Webb John G , Wijeysundera Harindra C 
Published: August 2023

Abstract

Background
Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR.

Methods
Data were collected from the “Infectious Endocarditis after TAVR International” (enrollment from 2005 to 2020) and the “International Collaboration on Endocarditis” (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR.

Results
A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P &lt; .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P &lt; .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P &lt; .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P &lt; .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697).

Conclusions
Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up.