title: Infective Endocarditis Risk After Percutaneous Pulmonary Valve Implantation With the Melody and Sapien Valves.
abstract: This study compared the risk of infective endocarditis (IE) after percutaneous pulmonary valve implantation (PPVI) with the Sapien and Melody valves.
  
  
  
  The incidence of IE after PPVI is estimated at 3% per year with the Melody valve. The Sapien valve is a more recently marketed valve used for PPVI.
  
  
  
  We retrospectively included consecutive patients who underwent PPVI at a single center between 2008 and 2016. IE was diagnosed using the modified DUKE criteria.
  
  
  
  PPVI was performed in 79 patients (Melody valve, 40.5%; Sapien valve, 59.5%). Median age was 24.9 years (range 18.1 to 34.6). IE occurred in 8 patients (10.1%) at a median of 1.8 years (minimum: 1.0; maximum: 5.6) after surgery. Causative organisms were methicillin-sensitive Staphylococcus aureus (n = 3), Staphylococcus epidermidis (n = 1), Streptococcus mitis (n = 1), Aerococcus viridans (n = 1), Corynebacterium striatum (n = 1), and Haemophilus influenzae (n = 1). All 8 cases occurred after Melody PPVI (25.0% vs. 0.0%). The incidence of IE was 5.7% (95% confidence interval: 2.9% to 11.4%) per person-year after Melody PPVI. The Kaplan-Meier cumulative incidence of IE with Melody PPVI was 24.0% (95% confidence interval: 12.2% to 43.9%) after 4 years and 30.1% (95% confidence interval: 15.8% to 52.5%) after 6 years, compared with 0.0% with the Sapien PPVI after 4 years (p < 0.04 by log-rank test). There was a trend toward a higher incidence of IE in the first 20 patients with Melody PPVI (who received prophylactic antibiotics during the procedure only) and in patients who had percutaneous interventions, dental care, or noncardiac surgery after PPVI.
  
  
  
  IE after PPVI may be less common with the Sapien compared with the Melody valve.
authors.affiliation: Hospital Marie Lannelongue, Congenital Heart Diseases Department, Complex Congenital Heart Diseases M3C Network, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France. Electronic address: s.hascoet@ccml.fr.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Hascoet
authors.affiliation: Hospital Marie Lannelongue, Congenital Heart Diseases Department, Complex Congenital Heart Diseases M3C Network, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mauri
authors.affiliation: Hospital Marie Lannelongue, Congenital Heart Diseases Department, Complex Congenital Heart Diseases M3C Network, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Claude
authors.affiliation: Hospital Marie Lannelongue, Congenital Heart Diseases Department, Complex Congenital Heart Diseases M3C Network, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Fournier
authors.affiliation: Hospital Saint-Joseph, Department of Microbiology, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Lourtet
authors.affiliation: Hospital Marie Lannelongue, Imaging and Interventional Radiology Department, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Riou
authors.affiliation: Hospital Marie Lannelongue, Imaging and Interventional Radiology Department, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brenot
authors.affiliation: Hospital Marie Lannelongue, Congenital Heart Diseases Department, Complex Congenital Heart Diseases M3C Network, Paris-Sud University, Paris-Saclay University, Plessis-Robinson, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Petit
mesh_terms: D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D010297:Paris / Q000453:epidemiology; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D065840:Protective Factors; D011664:Pulmonary Valve / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Melody valve; Sapien valve; cardiac valve; congenital heart defects; infective endocarditis; percutaneous pulmonary valve implantation