Infective endocarditis following transcatheter aortic valve replacement: Diagnostic yield of echocardiography and associated echo-Doppler findings.

Published on Nov 15, 2018in International Journal of Cardiology3.229
· DOI :10.1016/J.IJCARD.2018.03.124
William R. Miranda14
Estimated H-index: 14
(Mayo Clinic),
Heidi M. Connolly75
Estimated H-index: 75
(Mayo Clinic)
+ 8 AuthorsSorin V. Pislaru36
Estimated H-index: 36
(Mayo Clinic)
Sources
Abstract
Abstract Background Studies have suggested the diagnostic yield of echocardiography to be lower in prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement (TAVR) than reported in surgically-implanted valves but data are limited. Methods We reviewed transthoracic (TTE) and transesophageal (TEE) echo-Doppler findings in 17 patients with PVE (13 definite and 4 possible cases according to modified Duke criteria) after TAVR at Mayo Clinic, Rochester, MN between 2007 and 2016. Results Median age was 81 years [56; 91] and 5 patients (29%) were female. Median Society of Thoracic Surgery predicted risk of mortality was 8.8%. PVE occurred 197 days [27; 923] after TAVR. Enterococcus faecalis was the most commonly encountered organism (29%). All patients had TEE performed at the time of PVE; TTE was performed in 11 patients. TEE was diagnostic for PVE in 47% of cases and TTE in 18%. TEE was diagnostic in 62% of patients if only definite PVE cases are included. Two patients showed prosthetic obstruction at the time of PVE; obstruction improved with antibiotic therapy in the surviving patient. Conclusion Standard echocardiography techniques had limited diagnostic performance in patients with TAVR-related PVE. PVE can present as features of TAVR obstruction, thus PVE should also be considered in patients presenting with worsening prosthetic obstruction.
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#2Laura SportouchH-Index: 1
Last. Gilbert Habib (French Institute of Health and Medical Research)H-Index: 1
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Diagnosis of infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) remains difficult to establish using modified Duke criteria. We present the value of multi-imaging approach (European Society of Cardiology [ESC]-2015 modified criteria) [(1)][1] in 16 patients referred for
37 CitationsSource
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Last. Bjarne Linde Nørgaard (Aarhus University Hospital)H-Index: 51
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Abstract Background There are limited data on the incidence, clinical implications, and predisposing factors of transcatheter heart valve (THV) thrombosis following transcatheter aortic valve replacement (TAVR). Objectives The authors assessed the incidence, potential predictors, and clinical implications of THV thrombosis as determined by contrast-enhanced multidetector computed tomography (MDCT) after TAVR. Methods Among 460 consecutive patients who underwent TAVR with the Edwards Sapien XT or...
211 CitationsSource
#1Ander Regueiro (Laval University)H-Index: 21
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Last. Josep Rodés-Cabau (Laval University)H-Index: 95
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Importance Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). Objective To determine the associated factors, clinical characteristics, and outcomes of patients who had infective endocarditis after TAVR. Design, Setting, and Participants The Infectious Endocarditis after TAVR International Registry included patients with definite infective endocarditis after TAVR from 47 centers fro...
144 CitationsSource
#1William R. Miranda (Mayo Clinic)H-Index: 14
#2Heidi M. Connolly (Mayo Clinic)H-Index: 75
Last. Larry M. Baddour (Mayo Clinic)H-Index: 90
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Aims To review clinical and microbiological findings in adults with prosthetic pulmonary valve (PPV) or right ventricle to pulmonary artery conduit (RVPAC) infective endocarditis (IE) and to assess the yield of transthoracic (TTE) and transesophageal echocardiography (TEE) as diagnostic tools. Methods and results Seventeen adults (age ≥18 years) with PPV/RVPAC who met diagnostic criteria for definite IE between 2000 and 2015 were included. Median age was 34 years and 29% were females; four patie...
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#2Marco Schiavo LenaH-Index: 1
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An 83-year-old woman with multiple autoimmune disorders treated with corticosteroids was admitted to emergency department for heart failure and fever, after 1 year from implantation of trans-aortic valve (23-mm-Edward-Sapien-3). Diagnosis of definitive infective endocarditis was achieved: positive blood cultures for Streptococcus Gallolyticus and transoesophageal echocardiography (TEE) showing high trans-prosthesis gradients (mean-gradient 60 mmHg) and 15-mm-fluctuating vegetation on prosthetic ...
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#1Jeremy Ben-ShoshanH-Index: 13
#2Sharon AmitH-Index: 13
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During the last decade, transcatheter aortic valve implantation (TAVI) has become a widespread procedure for the treatment of symptomatic severe aortic stenosis in patients with high surgical risk. In conjunction with the growing experience, the adverse outcomes of TAVI have arisen, including transcatheter aortic valve infective endocarditis (TAVIE). Although rare, TAVIE has been shown as a major etiology of transcatheter aortic valve failure and its magnitude is expected to increase as TAVI wil...
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#1Alexander C. Egbe (Mayo Clinic)H-Index: 20
#2Sorin V. Pislaru (Mayo Clinic)H-Index: 36
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Abstract Background Bioprosthetic valve thrombosis (BPVT) is considered uncommon; this may be related to the fact that it is often unrecognized. Recent data suggest that BPVT responds to vitamin K antagonists, emphasizing the need for reliable diagnosis. Objectives This study sought to determine the diagnostic features of BPVT and to formulate a diagnostic model for BPVT. Methods Cases of BPVT occurring between 1997 and 2013 were identified from the Mayo Clinic pathology database. Patients with ...
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#1Gilbert HabibH-Index: 90
#2Patrizio LancellottiH-Index: 109
Last. José Luis ZamoranoH-Index: 82
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3D : three-dimensional AIDS : acquired immune deficiency syndrome b.i.d. : bis in die (twice daily) BCNIE : blood culture-negative infective endocarditis CDRIE : cardiac device-related infective endocarditis CHD : congenital heart disease CIED : cardiac implantable electronic device
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#1Raj Makkar (CUMC: Columbia University Medical Center)H-Index: 89
#2Gregory P. Fontana (UCL: University College London)H-Index: 15
Last. Lars Søndergaard (UCPH: University of Copenhagen)H-Index: 65
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BackgroundA finding of reduced aortic-valve leaflet motion was noted on computed tomography (CT) in a patient who had a stroke after transcatheter aortic-valve replacement (TAVR) during an ongoing clinical trial. This finding raised a concern about possible subclinical leaflet thrombosis and prompted further investigation. MethodsWe analyzed data obtained from 55 patients in a clinical trial of TAVR and from two single-center registries that included 132 patients who were undergoing either TAVR ...
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#1Darren Mylotte (MUHC: McGill University Health Centre)H-Index: 24
#1Darren Mylotte (MUHC: McGill University Health Centre)H-Index: 11
Last. Nicolo Piazza (MUHC: McGill University Health Centre)H-Index: 34
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Aims A comprehensive description of transcatheter heart valve (THV) failure has not been performed. We undertook a systematic review to investigate the aetiology, diagnosis, management, and outcomes of THV failure. Methods and results The systematic review was performed in accordance with the PRISMA guidelines using EMBASE, MEDLINE, and Scopus. Between December 2002 and March 2014, 70 publications reported 87 individual cases of transcatheter aortic valve implantation (TAVI) failure. Similar to ...
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