Infective endocarditis (IE) is a rare but potentially fatal complication associated with transcatheter aortic valve replacement (TAVR). What does it mean for the patient’s health if they also experience a stroke? A team of researchers out of Canada and Germany aimed to find out, sharing their findings in the Journal of the American College of Cardiology.
The study’s authors explored data from more than 40,000 TAVR patients, identifying 569 who developed IE following the procedure. All patients were treated in one of 11 different counties across North America, South America and Europe from June 2005 to November 2020.
Overall, 10% of patients had a stroke while they were hospitalized for post-TAVR IE. Patients in the stroke (S-IE) group had higher rates of acute renal failure, systemic embolization and persistent bacteremia than patients who did not have a stroke (NS-IE). A previous stroke prior to IE, a significant amount of post-TAVR residual aortic regurgitation, balloon-expandable heart valves, a short time between TAVR and IE and a vegetation size greater than 8 mm were all associated with a heightened risk of stroke.
In-hospital mortality was 54.4% for the S-IE group and 28.7% for the NS-IE group. All-cause mortality after one year, meanwhile, was 66.3% for the S-IE group and 45.6% for the NS-IE group.
“TAVR has revolutionized the treatment of aortic stenosis and is currently moving toward less complex and younger patients with lower surgical risk,” wrote lead author David del Val, MD, of the Quebec Heart and Lung Institute at Laval University in Quebec, Canada, and colleagues. “Despite the relatively low incidence of IE after TAVR, the number of procedures is expected to grow exponentially, increasing the number of patients at risk of developing this life-threatening complication. Therefore, detailed knowledge of this disease and its complications is essential to improve outcomes.”
Earlier surgical interventions may be an effective way to help TAVR patients with certain risk factors, the team noted, but additional research is still needed to know for sure.
Click here to read the team’s full analysis.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.