14 Sep Study Outlines Risk Factors for Infectious Endocarditis After TAVR
MedicalResearch.com Interview with:
Josep Rodés-Cabau, MD
Director, Catheterization and Interventional Laboratories
Quebec Heart and Lung Institute
Professor, Faculty of Medicine, Laval University
Quebec City, Quebec, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Infectious endocarditis (IE) is one of the most serious complications after surgical prosthetic valve replacement. There are however scarce data regarding the incidence, predictive factors, treatment, and outcomes of IE post-TAVR. To date, the present study represents the largest series of IE post-TAVR, and the main findings can be summarized as follows: (1) the incidence of infective endocarditis (IE) post-TAVR is similar to that reported for IE after surgical prosthetic valve replacement; (2) among patients undergoing TAVR, younger age, male sex, a history of diabetes mellitus, and moderate-to-severe residual aortic regurgitation were associated with a higher risk of IE, (3) Enterococci species was the most frequently isolated pathogen, (4) IE post-TAVR was associated with a very high rate of in-hospital complications and mortality during index hospitalization and at follow-up.
MedicalResearch.com: What should readers take away from your report?
Response: Infectious endocarditis is a rare but very serious complication following TAVR. The prevention is therefore of outmost importance. Infectious endocarditis post-TAVR is health-care related in more than half of patients; avoiding unnecessary invasive procedures and selecting the appropriate antibiotic prophylaxis may be important in order to reduce the incidence of this life-threatening complication. Also, prompt diagnosis and appropriate treatment are very important. The fact that Enterococci species and Staphylococcus aureus are the 2 most frequent microorganisms may help us to guide our initial antibiotic therapy strategy. The role of valve explantation in this very high risk group of patients should be further evaluated.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our efforts should focus on preventive measures. Also, the best antibiotic prophylaxis strategy during TAVR procedures should be determined. Further measures for improving the diagnosis and treatment of IE post-TAVR need to be evaluated.
Finally, TAVR is expanding towards the treatment of intermediate- and low-risk patients. Future studies evaluating the incidence and outcomes of IE post-TAVR in intermediate- and low-risk patients are needed.
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