title: Infective endocarditis in patients with an implanted transcatheter aortic valve: Clinical characteristics and outcome of a new entity.
abstract: OBJECTIVE
  This study reports one case and review the literature on TAVI-associated endocarditis (TAVIE), to describe its clinical picture and to perform an analysis on prognostic factors.
  
  
  RESULTS
  A MEDLINE search from January 2002 to October 2014 revealed 31 cases of TAVIE, including 1 from our hospital. Median age was 81 years (IQR, 78-85), 53% of patients were males and the median age-adjusted Charlson score was 7 (IQR, 5-8). Heart failure was recorded in 42%, embolic events in 19%, and periannular complications in 45%. The most common causative agent was Enterococcus spp (36%). Ten patients (32%) underwent surgery and nine patients died (29%). The prognostic factors for 6-month mortality were heart failure (HR, 9.97 [3.7-24.5]; p = 0.001), periannular complications (HR, 11.82 [3.3-41.3]; p = 0.004), and nonenterococcal/streptococcal etiology (HR, 4.76 [2.1-11.1]; p = 0.03). In patients with heart failure who did not undergo surgery, mortality was 89% (8 out of 9); in those who did undergo surgery, mortality was 0% (p < 0.001).
  
  
  CONCLUSIONS
  TAVIE is an emerging entity with high mortality. Patients with heart failure who did not undergo surgery had a higher probability of dying. Surgical treatment provided better outcomes even in patients in whom surgery had previously been ruled out.
authors.affiliation: Infectious Diseases Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. Electronic address: JPERICAS@clinic.ub.es.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Pericas
authors.affiliation: Department of Statistics, Faculty of Biology, University of Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Llopis
authors.affiliation: Infectious Diseases Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cervera
authors.affiliation: Internal Medicine Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Sacanella
authors.affiliation: Cardiology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Falces
authors.affiliation: Cardiology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Rut
authors.initials: R
authors.lastname: Andrea
authors.affiliation: Infectious Diseases Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Garcia de la Maria
authors.affiliation: Department of Cardiovascular Surgery, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Ninot
authors.affiliation: Cardiology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Bàrbara
authors.initials: B
authors.lastname: Vidal
authors.affiliation: Microbiology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Almela
authors.affiliation: Cardiology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Paré
authors.affiliation: Cardiology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
authors.affiliation: Infectious Diseases Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Asunción
authors.initials: A
authors.lastname: Moreno
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Microbiology Service, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Marco
authors.affiliation: Department of Cardiovascular Surgery, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Mestres
authors.affiliation: Infectious Diseases Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. Electronic address: jmmiro@ub.edu.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004696:Endocarditis / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011379:Prognosis; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000401:mortality; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infective endocarditis; Literature review; Outcome; TAVI; Transcatheter aortic valve implantation