Very early infective endocarditis after transcatheter aortic valve replacement.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Panagides Vassili, Abdel-Wahab Mohamed, Mangner Norman, Durand Eric, Ihlemann Nikolaj, Urena Marina, Pellegrini Costanza, Giannini Francesco, Scislo Piotr, Huczek Zenon, Landt Martin, Auffret Vincent, Sinning Jan Malte, Cheema Asim N, Nombela-Franco Luis, Chamandi Chekrallah, Campelo-Parada Francisco, Munoz-Garcia Erika, Herrmann Howard C, Testa Luca, Kim Won-Keun, Eltchaninoff Helene, Søndergaard Lars, Himbert Dominique, Husser Oliver, Latib Azeem, Le Breton Hervé, Servoz Clement, Gervais Philippe, Del Val David, Linke Axel, Crusius Lisa, Thiele Holger, Holzhey David, Rodés-Cabau Josep
Аннотация
OBJECTIVE: The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR.
METHODS: This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR.
RESULTS: Ninety-one patients (15.7%) had VE-IE. Factors associated with VE-IE (vs. delayed IE (D-IE)) were female gender (p = 0.047), the use of self-expanding valves (p < 0.001), stroke (p = 0.019), and sepsis (p < 0.001) after TAVR. Staphylococcus aureus was the main pathogen among VE-IE patients (35.2% vs. 22.7% in the D-IE group, p = 0.012), and 31.2% of Staphylococcus aureus infections in the VE-IE group were methicillin-resistant (vs. 14.3% in the D-IE group, p = 0.001). The second-most common germ was enterococci (34.1% vs. 24.4% in D-IE cases, p = 0.05). VE-IE was associated with very high in-hospital (44%) and 1-year (54%) mortality rates. Acute renal failure following TAVR (p = 0.001) and the presence of a non-enterococci pathogen (p < 0.001) were associated with an increased risk of death.
CONCLUSION: A significant proportion of IE episodes following TAVR occurs within a few weeks following the procedure and are associated with dismal outcomes. Some baseline and TAVR procedural factors were associated with VE-IE, and Staphylococcus aureus and enterococci were the main causative pathogens. These results may help to select the more appropriate antibiotic prophylaxis in TAVR procedures and guide the initial antibiotic therapy in those cases with a clinical suspicion of IE. Very early infective endocarditis after trans-catheter aortic valve replacement. VE-IE indicates very early infective endocarditis (≤30 days post TAVR). D-IE indicates delayed infective endocarditis.