Incidence and outcomes of infective endocarditis following transcatheter aortic valve implantation

Expert Rev Cardiovasc Ther. 2020 Oct;18(10):653-662. doi: 10.1080/14779072.2020.1839419. Epub 2020 Dec 1.

Abstract

Introduction: Prosthetic valve infective endocarditis is a feared and potentially catastrophic complication of valvular intervention. Transcatheter aortic valve implantation has transformed the modern management of aortic stenosis and vastly altered the demographics of those patients undergoing valve replacement.

Areas covered: As a relatively nascent development, what TAVI means for the epidemiology of infective endocarditis, how to identify those patients undergoing the procedure at greatest risk, and how best to prevent and manage the condition remains the subject of fervent research activity. In this review, we appraise relevant contemporary data discussing the incidence, microbiological profiles, associated risk factors and clinical outcomes of infective endocarditis after TAVI.

Expert opinion: Present outcomes are poor, with exceedingly high in-hospital and long-term mortality. Evidence to support surgical management in this patient group is lacking. Prevention is therefore paramount and a logical focus for future research attention.

Keywords: Infective endocarditis; SAVR; TAVI; TAVR; aortic stenosis; aortic valve replacement; echocardiography; positron emission tomographic (PET) imaging; prosthetic valve endocarditis; transcatheter valve interventions.

Publication types

  • Review

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis / surgery*
  • Endocarditis / etiology*
  • Humans
  • Incidence
  • Risk Factors
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Treatment Outcome