Ali, N, Baig, MW, Wu, J orcid.org/0000-0001-6093-599X et al. (3 more authors) (2020) Prosthetic valve endocarditis following transcatheter aortic valve implantation. Journal of Cardiovascular Medicine. ISSN 1558-2027
Abstract
Aims
The aims were to report the incidence and outcomes of transcatheter aortic valve implantation-infective endocarditis (TAVI-IE) from a high-volume TAVI centre in the United Kingdom, including how incidence varies relative to time from the procedure, and to assess the performance of modified Duke criteria in the diagnosis of TAVI-IE.
Methods
The retrospective, cohort study included all patients who underwent TAVI at Leeds Teaching Hospitals Trust during a 10-year period. Outcome measures were the incidence of TAVI-IE, the accuracy of the modified Duke criteria and the mortality rate.
Results
A total of 1337 patients were followed up for a median of 2.3 years. Thirteen patients (0.97%) were diagnosed with TAVI-IE, mean age of 81.3 years (SD 5.1 years). Four patients (30.8%) fulfilled modified Duke criteria for definite infective endocarditis. The remaining nine patients (69.2%) fulfilled the modified Duke criteria for possible infective endocarditis. In the majority (7/13; 53.8%) the causative organism was streptococcal. Cumulative incidence of TAVI-IE has risen in line with the number of patients living with TAVI prostheses, and cumulative number of TAVI-years. However, in relation to the number of 100 TAVI-years, the infection rate has remained low and static over the last 6 years. The in-hospital mortality rate was 38.5%, all attributable to TAVI-IE.
Conclusion
The incidence of TAVI-IE was 0.97%, with an associated all-cause mortality of 53.8%. The incidence relative to the number of TAVI-years has remained low and static in recent years. The modified Duke criteria have relatively low sensitivity in the diagnosis of TAVI-IE, meaning that a high index of suspicion is required.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 Italian Federation of Cardiology. This is an author produced version of a paper published in Journal of Cardiovascular Medicine. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | infective endocarditis, modified Duke criteria, transcatheter valve interventions |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Applied Health and Clinical Translation (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 12 Feb 2020 11:25 |
Last Modified: | 22 Apr 2021 00:38 |
Status: | Published online |
Publisher: | Lippincott, Williams & Wilkins |
Identification Number: | 10.2459/JCM.0000000000000961 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:156857 |