Introduction 

Infective endocarditis following transcatheter aortic valve replacement (TAVR) is an emerging problem, with a high rate of morbidity and mortality. However, little is known about the burden of disease, and data on infective endocarditis incidence are scarce. This study aimed to evaluate the incidence of infective endocarditis in TAVR by performing a systematic review and meta-analysis of the literature.

Methods 

We comprehensively searched the databases of MEDLINE and EMBASE from inception to October 2019. Included studies were prospective or retrospective cohort studies that reported the event rate of infective endocarditis in patients who underwent TAVR. Data from each study were combined using the random-effects method to calculate pooled incidence with 95% confidence intervals (CIs).

Results 

A total of 30 studies consisting of 73 780 patients undergoing TAVR were included in this meta-analysis. Overall, the pooled estimated incidence of infective endocarditis following TAVR was 7 in 1000 patients (95% CI: 0.5–1%). For early infective endocarditis, the pooled estimated incidence was 8 per 1000 patients (95% CI: 0.5–1.1%). For late infective endocarditis, the pooled estimated incidence was 2 in 1000 patients (95% CI: 0.1–0.4%). Significantly, the overall pooled infective endocarditis mortality rate was 39% (95% CI: 28.7–49.4%).

Conclusion 

The current study demonstrates the incidence of overall, early, and late infective endocarditis following TAVR, ranging from 2 to 8 per 1000 patients. Although it remains a rare event, infective endocarditis following TAVR is associated with high mortality.

中文翻译：

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经导管主动脉瓣置换术中感染性心内膜炎的流行病学：系统评价和荟萃分析

介绍 

感染性心内膜炎以下导管主动脉瓣置换（TAVR）是一种新兴的问题，与发病率和死亡率的高速率。但是，对疾病负担知之甚少，关于感染性心内膜炎发病率的数据很少。本研究旨在通过对文献进行系统的回顾和荟萃分析来评估TAVR中感染性心内膜炎的发生率。

方法 

从开始到2019年10月，我们全面搜索MEDLINE和EMBASE的数据库。纳入的研究为前瞻性或回顾性队列研究，报告了接受TAVR的患者感染性心内膜炎的发生率。使用随机效应方法将来自每个研究的数据进行合并，以95％置信区间（CI）来计算合并发生率。

结果 

这项荟萃分析共纳入30项研究，包括73780名接受TAVR的患者。总体而言，TAVR后合并的感染性心内膜炎的估计发病率是每1000例患者中7例（95％CI：0.5–1％）。对于早期感染性心内膜炎，汇总的估计发病率为每1000例患者8例（95％CI：0.5–1.1％）。对于晚期感染性心内膜炎，汇总的估计发生率为1000例患者中的2例（95％CI：0.1–0.4％）。值得注意的是，总的合并感染性心内膜炎死亡率为39％（95％CI：28.7–49.4％）。

结论 

当前的研究表明，TAVR后总体，早期和晚期感染性心内膜炎的发生率是每1000例患者2至8例。尽管这仍然是罕见的事件，但TAVR后的感染性心内膜炎与高死亡率相关。