Association Between Transcatheter Aortic Valve Replacement and Subsequent Infective Endocarditis and In-Hospital Death

Abstract

Infective endocarditis following surgical valve replacement occurs in 1% to 6% of patients and is associated with high morbidity and mortality.¹ Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic option for patients with aortic stenosis who are considered to be at high or prohibitive surgical risk.² The rate of infective endocarditis within the year following TAVR has been reported to be 1.5%, ranging from 0.5% to 3.1%,^3,4 similar to infective endocarditis rates after surgical valve replacement.^5,6 Greater exposure to health care procedures, older age, and a considerable amount of foreign material (eg, stent struts) of the transcatheter valve prostheses may have contributed to increase the risk of infective endocarditis in such patients. To date, data on infective endocarditis after TAVR have been limited to case reports and relatively small series with limited follow-up,^3,4,7-10 demonstrating in-hospital complication and mortality rates as high as 87% and 47%, respectively. Valve explantation rates in such patients remain relatively low (<10%). It is therefore relevant to further investigate the factors associated with and the clinical characteristics and outcomes of infective endocarditis after TAVR.