Infectious endocarditis on percutaneous aortic valve prosthesis: comparison with surgical bioprostheses

Introduction and objectives: Infective endocarditis (IE) is a rare but serious complication in patients with aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). The spread of this technique to lower risk patients means that this complication may increase. The objective of this study was to analyze the incidence and mortality of IE in TAVI patients vs patients Methods: We conducted an observational, single-center, retrospective cohort study that included all cases of IE diagnosed consecutively in a Spanish reference center from 2008 through 2022 in patients with TAVI vs SAVR. Results: The study included a total of 10 cases of IE in 778 patients treated with TAVI, with an incidence rate of 0.09/100 patients/ year vs an incidence rate of 0.12/100 patients/year in surgical bioprostheses with 24 cases in 1457 patients (P = .64) (median follow-up of 49 months (p25-p75: 29-108). Clinical features were very similar, with 50% of TAVI patients having cardiac complications vs 33% of SAVR patients (P = .33). Although 40% of the patients from the TAVI group had a surgical indication for IE and 50% for SAVR, P = .49), only half of them underwent surgery in both groups (20% TAVI vs 25% SAVR; P = .93). No differences were reported in the 1-year mortality rate (30% TAVI vs 29% SAVR; P = .56). Conclusions: The incidence rate of IE in this long series of TAVI patients was low and despite the worse clinical profile of TAVI patients, no significant mortality differences were found compared with the group of patients with surgical bioprosthesis.