Hospital Universitario de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa, CIBERCV, Madrid, Spain; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
J Am Coll Cardiol. 2023 Jan 31;81(4):394-412. doi: 10.1016/j.jacc.2022.11.028.
Infective endocarditis (IE) is a rare but serious complication following transcatheter aortic valve replacement (TAVR). Despite substantial improvements in the TAVR procedure (less invasive) and its expansion to younger and healthier patients, the incidence of IE after TAVR remains stable, with incidence rates similar to those reported after surgical aortic valve replacement. Although IE after TAVR is recognized as a subtype of prosthetic valve endocarditis, this condition represents a particularly challenging scenario given its unique clinical and microbiological profile, the high incidence of IE-related complications, the uncertain role of cardiac surgery, and the dismal prognosis in most patients with TAVR-IE. The number of TAVR procedures is expected to grow exponentially in the coming years, increasing the number of patients at risk of developing this life-threatening complication. Therefore, a detailed understanding of this disease and its complications will be essential to improve clinical outcomes.
感染性心内膜炎(IE)是经导管主动脉瓣置换术(TAVR)后的一种罕见但严重的并发症。尽管 TAVR 手术(微创)及其向更年轻、更健康的患者扩展取得了实质性进展,但 TAVR 后 IE 的发生率保持稳定,与手术后主动脉瓣置换术报告的发生率相似。尽管 TAVR 后 IE 被认为是人工瓣膜心内膜炎的一个亚型,但鉴于其独特的临床和微生物学特征、IE 相关并发症的高发生率、心脏手术的不确定作用以及大多数 TAVR-IE 患者的预后不良,这种情况代表了一个特别具有挑战性的情况。在未来几年,TAVR 手术的数量预计将呈指数级增长,增加了发生这种危及生命的并发症的患者人数。因此,详细了解这种疾病及其并发症对于改善临床结果至关重要。