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Transcatheter heart valve explant with infective endocarditis-associated prosthesis failure and outcomes: the EXPLANT-TAVR international registry.
Marin-Cuartas, Mateo; Tang, Gilbert H L; Kiefer, Philipp; Fukuhara, Shinichi; Lange, Rudiger; Harrington, Katherine B; Saha, Shekhar; Hagl, Christian; Kleiman, Neal S; Goel, Sachin S; Kempfert, Joerg; Werner, Paul; Petrossian, George A; Geirsson, Arnar; Desai, Nimesh D; Chu, Michael W A; Bhadra, Oliver D; Shults, Christian; Garatti, Andrea; Vincent, Flavien; Grubb, Kendra J; Goldberg, Joshua B; Mack, Michael J; Modine, Thomas; Denti, Paolo; Kaneko, Tsuyoshi; Bapat, Vinayak N; Reardon, Michael J; Borger, Michael A; Zaid, Syed.
Afiliación
  • Marin-Cuartas M; University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
  • Tang GHL; Department of Cardiovascular Surgery, Mount Sinai Medical Center, 1190 Fifth Avenue, GP2W, Box 1028, New York, NY 10029, USA.
  • Kiefer P; University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
  • Fukuhara S; University of Michigan, Ann Arbor, MI, USA.
  • Lange R; German Heart Center Munich, Munich, Germany.
  • Harrington KB; Baylor, Scott & White The Heart Hospital, Plano, TX, USA.
  • Saha S; Department of Cardiac Surgery, Ludwig Maximillian University Munich, Munich, Germany.
  • Hagl C; German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.
  • Kleiman NS; Department of Cardiac Surgery, Ludwig Maximillian University Munich, Munich, Germany.
  • Goel SS; German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.
  • Kempfert J; Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
  • Werner P; German Heart Center Berlin at Charité, Berlin, Germany.
  • Petrossian GA; German Heart Center Berlin at Charité, Berlin, Germany.
  • Geirsson A; Medical University of Vienna, Vienna, Austria.
  • Desai ND; St. Francis Hospital, Roslyn, NY, USA.
  • Chu MWA; Columbia University Irving Medical Center, New York, NY, USA.
  • Bhadra OD; University of Pennsylvania, Philadelphia, PA, USA.
  • Shults C; London Health Sciences Center, Western University, London, ON, Canada.
  • Garatti A; Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany.
  • Vincent F; MedStar Washington Hospital Center, Washington, DC, USA.
  • Grubb KJ; IRCCS Policlinico San Donato, Milan, Italy.
  • Goldberg JB; CHU Lille, University of Lille, Lille, France.
  • Mack MJ; Emory University, Atlanta, GA, USA.
  • Modine T; Westchester Medical Center, Valhalla, NY, USA.
  • Denti P; Baylor, Scott & White The Heart Hospital, Plano, TX, USA.
  • Kaneko T; CHU Bordeaux, Bordeaux, France.
  • Bapat VN; San Raffaele University Hospital, Milan, Italy.
  • Reardon MJ; Washington University School of Medicine, St. Louis, MO, USA.
  • Borger MA; Abbott Northwestern Hospital, Minneapolis, MN, USA.
  • Zaid S; Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
Eur Heart J ; 45(28): 2519-2532, 2024 Jul 21.
Article en En | MEDLINE | ID: mdl-38820201
ABSTRACT
BACKGROUND AND

AIMS:

Surgical explantation of transcatheter heart valves (THVs) is rapidly increasing, but there are limited data on patients with THV-associated infective endocarditis (IE). This study aims to assess the outcomes of patients undergoing THV explant for IE.

METHODS:

All patients who underwent THV explant between 2011 and 2022 from 44 sites in the EXPLANT-TAVR registry were identified. Patients with IE as the reason for THV explant were compared to those with other mechanisms of bioprosthetic valve dysfunction (BVD).

RESULTS:

A total of 372 patients from the EXPLANT-TAVR registry were included. Among them, 184 (49.5%) patients underwent THV explant due to IE and 188 (50.5%) patients due to BVD. At the index transcatheter aortic valve replacement, patients undergoing THV explant for IE were older (74.3 ± 8.6 vs. 71 ± 10.6 years) and had a lower Society of Thoracic Surgeons risk score [2.6% (1.8-5.0) vs. 3.3% (2.1-5.6), P = .029] compared to patients with BVD. Compared to BVD, IE patients had longer intensive care unit and hospital stays (P < .05) and higher stroke rates at 30 days (8.6% vs. 2.9%, P = .032) and 1 year (16.2% vs. 5.2%, P = .010). Adjusted in-hospital, 30-day, and 1-year mortality was 12.1%, 16.1%, and 33.8%, respectively, for the entire cohort, with no significant differences between groups. Although mortality was numerically higher in IE patients 3 years postsurgery (29.6% for BVD vs. 43.9% for IE), Kaplan-Meier analysis showed no significant differences between groups (P = .16).

CONCLUSIONS:

In the EXPLANT-TAVR registry, patients undergoing THV explant for IE had higher 30-day and 1-year stroke rates and longer intensive care unit and hospital stays. Moreover, patients undergoing THV explant for IE had a higher 3-year mortality rate, which did not reach statistical significance given the relatively small sample size of this unique cohort and the reduced number of events.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Falla de Prótesis / Sistema de Registros / Infecciones Relacionadas con Prótesis / Endocarditis / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Falla de Prótesis / Sistema de Registros / Infecciones Relacionadas con Prótesis / Endocarditis / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido