Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis
Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016...
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MDPI AG
2023-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/16/5177 |
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| author | Romina Maria Rösch Lena Brendel Katja Buschmann Christian-Friedrich Vahl Hendrik Treede Daniel-Sebastian Dohle |
| author_facet | Romina Maria Rösch Lena Brendel Katja Buschmann Christian-Friedrich Vahl Hendrik Treede Daniel-Sebastian Dohle |
| author_sort | Romina Maria Rösch |
| collection | DOAJ |
| description | Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016 and July 2019, ten patients underwent surgery due to prosthetic-valve endocarditis after TAVR. They were identified in our institutional database and analyzed. Results: Infective endocarditis was diagnosed 17 ± 16 month after TAVR. Mean age was 79 ± 4.4 years. Microbiological detection showed 6/10 positive blood cultures for enterococcus faecalis. Median EuroScore II was 24.64%. The mean size of the surgically replaced aortic prosthesis was 23.6 ± 1.3 and that of the TAVR was 28.4 ± 2.3 mm. The surgically implanted aortic valves had a mean gradient of 8.5 ± 2.2 mmHg. One patient died in hospital due to septic multiorgan failure. After discharge, all patients survived with a mean follow-up of 9 ± 8 month. Conclusions: With a rising number of patients after TAVR, prosthetic-valve endocarditis will increasingly occur in patients who were previously considered high or intermediate risk. Our results show that patients with TAVR infective endocarditis can be operated on with good results. Surgical therapy should not be withheld from TAVR patients with infective endocarditis. |
| first_indexed | 2024-03-10T23:50:37Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T23:50:37Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8d6497a3a36d4d09b983dd29ec9326de2023-11-19T01:38:58ZengMDPI AGJournal of Clinical Medicine2077-03832023-08-011216517710.3390/jcm12165177Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center AnalysisRomina Maria Rösch0Lena Brendel1Katja Buschmann2Christian-Friedrich Vahl3Hendrik Treede4Daniel-Sebastian Dohle5Department of Thoracic Surgery, Thoraxklinik Heidelberg, Heidelberg University Hospital, 69126 Heidelberg, GermanyDepartment of Thoracic Surgery, Thoraxklinik Heidelberg, Heidelberg University Hospital, 69126 Heidelberg, GermanyUniversity Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, GermanyUniversity Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, GermanyUniversity Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, GermanyUniversity Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, GermanyTranscatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016 and July 2019, ten patients underwent surgery due to prosthetic-valve endocarditis after TAVR. They were identified in our institutional database and analyzed. Results: Infective endocarditis was diagnosed 17 ± 16 month after TAVR. Mean age was 79 ± 4.4 years. Microbiological detection showed 6/10 positive blood cultures for enterococcus faecalis. Median EuroScore II was 24.64%. The mean size of the surgically replaced aortic prosthesis was 23.6 ± 1.3 and that of the TAVR was 28.4 ± 2.3 mm. The surgically implanted aortic valves had a mean gradient of 8.5 ± 2.2 mmHg. One patient died in hospital due to septic multiorgan failure. After discharge, all patients survived with a mean follow-up of 9 ± 8 month. Conclusions: With a rising number of patients after TAVR, prosthetic-valve endocarditis will increasingly occur in patients who were previously considered high or intermediate risk. Our results show that patients with TAVR infective endocarditis can be operated on with good results. Surgical therapy should not be withheld from TAVR patients with infective endocarditis.https://www.mdpi.com/2077-0383/12/16/5177infective endocarditisprosthetic-valve endocarditistranscatheter aortic-valve implantationvalve repairheart-valve prosthesisheart-valve pathologies |
| spellingShingle | Romina Maria Rösch Lena Brendel Katja Buschmann Christian-Friedrich Vahl Hendrik Treede Daniel-Sebastian Dohle Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis Journal of Clinical Medicine infective endocarditis prosthetic-valve endocarditis transcatheter aortic-valve implantation valve repair heart-valve prosthesis heart-valve pathologies |
| title | Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis |
| title_full | Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis |
| title_fullStr | Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis |
| title_full_unstemmed | Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis |
| title_short | Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis |
| title_sort | surgery for infective endocarditis after primary transcatheter aortic valve replacement a retrospective single center analysis |
| topic | infective endocarditis prosthetic-valve endocarditis transcatheter aortic-valve implantation valve repair heart-valve prosthesis heart-valve pathologies |
| url | https://www.mdpi.com/2077-0383/12/16/5177 |
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