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<p>Transcatheter aortic valve implantation (TAVI) is increasingly also being used in patients with low surgical risk, making long-term complications such as structural valve degeneration and infective endocarditis (IE) a&#xa0;growing concern. Nowadays, IE is one of the most common causes of transcatheter valve failure and can lead to the necessity for surgical explantation, although these procedures are technically demanding and high-risk.</p><p>The aim of the study was to compare outcomes following TAVI explantation due to IE versus other causes of bioprosthetic valve dysfunction (BVD). A&#xa0;total of 372 patients from the international EXPLANT-TAVR registry were analyzed, of whom 184 (49.5%) had IE and 188 (50.5%) had BVD. At the time of the index TAVI, patients with IE were older (mean age&#xa0;74 vs.&#xa0;71&#xa0;years) but had a&#xa0;lower preoperative risk (mean Society of Thoracic Surgeons, STS score&#xa0;2.6% vs.&#xa0;3.3%). Compared to those with BVD, they had longer intensive care (96&#xa0;vs.&#xa0;72 h) and hospital stays (15&#xa0;vs.&#xa0;11&#xa0;days) as well as higher stroke rates at 30&#xa0;days (8.6% vs.&#xa0;2.9%) and at 1&#xa0;year (16.2% vs.&#xa0;5.2%).</p><p>The adjusted mortality in hospital was 12.1%, 16.1% at 30&#xa0;days and 33.8% at 1&#xa0;year, with no significant differences between IE and BVD. The 3‑year mortality was also not statistically different, although it was numerically higher in the IE group (43.9% vs. 29.6%).</p><p>In summary, among patients undergoing TAVI explantation surgery, those with IE had a&#xa0;higher morbidity and a&#xa0;clinically but not statistically significant increased mortality rate compared to other causes of BVD.</p>

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Transkatheter-Herzklappen-Explantation bei mit infektiöser Endokarditis assoziiertem Prothesenversagen und Behandlungsergebnisse: das internationale EXPLANT-TAVR-Register

  • 期刊论文

  • 发表日期：

    2026年6月2日

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  • Mateo Marin-Cuartas,
  • Andres Lezama-Armenta,
  • Michael A. Borger,
  • Thomas Schröter,
  • Philipp Kiefer

摘要

Transcatheter aortic valve implantation (TAVI) is increasingly also being used in patients with low surgical risk, making long-term complications such as structural valve degeneration and infective endocarditis (IE) a growing concern. Nowadays, IE is one of the most common causes of transcatheter valve failure and can lead to the necessity for surgical explantation, although these procedures are technically demanding and high-risk.

The aim of the study was to compare outcomes following TAVI explantation due to IE versus other causes of bioprosthetic valve dysfunction (BVD). A total of 372 patients from the international EXPLANT-TAVR registry were analyzed, of whom 184 (49.5%) had IE and 188 (50.5%) had BVD. At the time of the index TAVI, patients with IE were older (mean age 74 vs. 71 years) but had a lower preoperative risk (mean Society of Thoracic Surgeons, STS score 2.6% vs. 3.3%). Compared to those with BVD, they had longer intensive care (96 vs. 72 h) and hospital stays (15 vs. 11 days) as well as higher stroke rates at 30 days (8.6% vs. 2.9%) and at 1 year (16.2% vs. 5.2%).

The adjusted mortality in hospital was 12.1%, 16.1% at 30 days and 33.8% at 1 year, with no significant differences between IE and BVD. The 3‑year mortality was also not statistically different, although it was numerically higher in the IE group (43.9% vs. 29.6%).

In summary, among patients undergoing TAVI explantation surgery, those with IE had a higher morbidity and a clinically but not statistically significant increased mortality rate compared to other causes of BVD.