title: Prosthetic valve endocarditis after transcatheter valve replacement: a systematic review.
abstract: OBJECTIVE
  The aim of this review is to describe the incidence, features, predisposing factors, and outcomes of prosthetic valve endocarditis (PVE) after transcatheter valve replacement (TVR).
  
  
  BACKGROUND
  Very few data exist on PVE after TVR.
  
  
  METHODS
  Studies published between 2000 and 2013 regarding PVE in patients with transcatheter aortic valve replacement (TAVR) or transcatheter pulmonary valve replacement (TPVR) were identified through a systematic electronic search.
  
  
  RESULTS
  A total of 28 publications describing 60 patients (32 TAVRs, 28 TPVRs) were identified. Most TAVR patients (66% male, 80 ± 7 years of age) had a very high-risk profile (mean logistic EuroSCORE: 30.4 ± 14.0%). In TPVR patients (90% male, 19 ± 6 years of age), PVE was more frequent in the stenotic conduit/valve (61%). The median time between TVR and infective endocarditis was 5 months (interquartile range: 2 to 9 months). Typical microorganisms were mostly found with a higher incidence of enterococci after TAVR (34.4%), and Staphylococcus aureus after TPVR (29.4%). As many as 60% of the TAVR-PVE patients were managed medically despite related complications such as local extension, embolism, and heart failure in more than 50% of patients. The valve explantation rate was 57% and 23% in balloon- and self-expandable valves, respectively. In-hospital mortality for TAVR-PVE was 34.4%. Most TPVR-PVE patients (75%) were managed surgically, and in-hospital mortality was 7.1%.
  
  
  CONCLUSIONS
  Most cases of PVE post-TVR involved male patients, with a very high-risk profile (TAVR) or underlying stenotic conduit/valve (TPVR). Typical, but different, microorganisms of PVE were involved in one-half of the TAVR and TPVR cases. Most TPVR-PVE patients were managed surgically as opposed to TAVR patients, and the mortality rate was high, especially in the TAVR cohort.
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada; Department of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Ignacio J
authors.initials: IJ
authors.lastname: Amat-Santos
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Henrique B
authors.initials: HB
authors.lastname: Ribeiro
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Marina
authors.initials: M
authors.lastname: Urena
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Allende
authors.affiliation: Department of Pediatric Cardiology, Centre Mère-Enfant, Quebec City, Quebec, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Houde
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bédard
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Perron
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: DeLarochellière
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Paradis
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Dumont
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Doyle
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Siamak
authors.initials: S
authors.lastname: Mohammadi
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Côté
authors.affiliation: Department of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: José Alberto
authors.initials: JA
authors.lastname: San Roman
authors.affiliation: Department of Cardiology, Quebec Heart & Lung Institute, Quebec City, Quebec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca.
authors.forename: Josep
authors.initials: J
authors.lastname: Rodés-Cabau
mesh_terms: D004696:Endocarditis / Q000453:epidemiology / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D011664:Pulmonary Valve / Q000601:surgery*; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: infective endocarditis; transcatheter aortic valve implantation; transcatheter pulmonary valve implantation