Aims 

The aims were to report the incidence and outcomes of transcatheter aortic valve implantation-infective endocarditis (TAVI-IE) from a high-volume TAVI centre in the United Kingdom, including how incidence varies relative to time from the procedure, and to assess the performance of modified Duke criteria in the diagnosis of TAVI-IE.

Methods 

The retrospective, cohort study included all patients who underwent TAVI at Leeds Teaching Hospitals Trust during a 10-year period. Outcome measures were the incidence of TAVI-IE, the accuracy of the modified Duke criteria and the mortality rate.

Results 

A total of 1337 patients were followed up for a median of 2.3 years. Thirteen patients (0.97%) were diagnosed with TAVI-IE, mean age of 81.3 years (SD 5.1 years). Four patients (30.8%) fulfilled modified Duke criteria for definite infective endocarditis. The remaining nine patients (69.2%) fulfilled the modified Duke criteria for possible infective endocarditis. In the majority (7/13; 53.8%) the causative organism was streptococcal. Cumulative incidence of TAVI-IE has risen in line with the number of patients living with TAVI prostheses, and cumulative number of TAVI-years. However, in relation to the number of 100 TAVI-years, the infection rate has remained low and static over the last 6 years. The in-hospital mortality rate was 38.5%, all attributable to TAVI-IE.

Conclusion 

The incidence of TAVI-IE was 0.97%, with an associated all-cause mortality of 53.8%. The incidence relative to the number of TAVI-years has remained low and static in recent years. The modified Duke criteria have relatively low sensitivity in the diagnosis of TAVI-IE, meaning that a high index of suspicion is required.

中文翻译：

---

经导管主动脉瓣植入术后人工瓣膜心内膜炎。

目的 

目的是报告英国高容量TAVI中心的经导管主动脉瓣植入性感染性心内膜炎（TAVI-IE）的发病率和结局，包括发病率相对于手术时间的变化，并评估其性能的改性Duke标准在TAVI-IE的诊断。

方法 

这项回顾性队列研究包括所有在十年期间在利兹教学医院基金会接受TAVI治疗的患者。结果指标为TAVI-IE的发生率，修订的Duke标准的准确性和死亡率。

结果 

总共对1337例患者进行了随访，中位数为2.3年。13例患者（0.97％）被诊断出患有TAVI-IE，平均年龄为81.3岁（标准差5.1岁）。4例患者（30.8％）符合明确的传染性心内膜炎的改良Duke标准。其余9名患者（69.2％）符合针对可能的感染性心内膜炎的修订的杜克标准。在大多数（7/13； 53.8％）中，致病菌是链球菌。TAVI-IE的累积发生率与使用TAVI假体的患者数量以及TAVI年的累积数量一致。但是，相对于100个TAVI年，在过去6年中，感染率一直很低且保持不变。院内死亡率为38.5％，均归因于TAVI-IE。

结论 

TAVI-IE的发生率为0.97％，相关的全因死亡率为53.8％。近年来，相对于TAVI年数的发病率仍然很低且保持不变。所述改性Duke标准具有在TAVI-IE的诊断灵敏度较低，这意味着高度怀疑指数是必需的。