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)
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.
#1Erwan SalaunH-Index: 15
#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
#1Nicolaj C. Hansson (Aarhus University Hospital)H-Index: 11
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
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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...
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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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#1Darren Mylotte (MUHC: McGill University Health Centre)H-Index: 24
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