Background:No data exist about the characteristics of infective endocarditis (IE) post-transcatheter aortic valve replacement (TAVR) according to transcatheter valve type. We aimed to determine the incidence, clinical characteristics, and outcomes of patients with IE post-TAVR treated with balloon-expandable valve (BEV) versus self-expanding valve (SEV) systems.Methods:Data from the multicenter Infectious Endocarditis After TAVR International Registry was used to compare IE patients with BEV versus SEV.Results:A total of 245 patients with IE post-TAVR were included (SEV, 47%; BEV, 53%). The timing between TAVR and IE was similar between groups (SEV, 5.5 [1.2–15] months versus BEV, 5.3 [1.7–11.4] months; P=0.89). Enterococcal IE was more frequent in the SEV group (36.5% versus 15.4%; P<0.01), and vegetation location differed according to valve type (stent frame, SEV, 18.6%; BEV, 6.9%; P=0.01; valve leaflet, SEV, 23.9%; BEV, 38.5%; P=0.01). BEV recipients had a higher rate of stroke/systemic embolism (20.0% versus 8.7%, adjusted OR: 2.46, 95% CI: 1.04–5.82, P=0.04). Surgical explant of the transcatheter valve (SEV, 8.7%; BEV, 13.8%; P=0.21), and in-hospital death at the time of IE episode (SEV, 35.6%; BEV, 37.7%; P=0.74) were similar between groups. After a mean follow-up of 13±12 months, 59.1% and 54.6% of the SEV and BEV recipients, respectively, had died (P=0.66).Conclusions:The characteristics of IE post-TAVR, including microorganism type, vegetation location, and embolic complications but not early or late mortality, differed according to valve type. These results may help to guide the diagnosis and management of IE and inform future research studies in the field.

中文翻译：

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经导管主动脉瓣置换术后的感染性心内膜炎：球囊与自膨胀瓣膜的比较。

背景：目前尚无有关经导管主动脉瓣类型的经导管主动脉瓣置换后感染性心内膜炎（IE）的特征的数据。我们旨在确定使用球囊扩张阀（BEV）与自扩张阀（SEV）系统治疗的TAVR后IE患者的发病率，临床特征和结局。结果：共纳入245例TAVR后IE患者（SEV，47％； BEV，53％）。各组之间TAVR和IE的时间相似（SEV为5.5 [1.2-15]个月，而BEV为5.3 [1.7-11.4]个月；P = 0.89）。肠球菌IE在SEV组中更为频繁（36.5％对15.4％；P<0.01），植被位置因瓣膜类型而异（支架框架，SEV，18.6％; BEV，6.9％; P = 0.01;瓣膜小叶，SEV，23.9％; BEV，38.5％; P = 0.01）。BEV接受者的中风/全身性栓塞发生率较高（20.0％比8.7％，校正OR：2.46，95％CI：1.04-5.82，P = 0.04）。经导管瓣膜的手术外植体（SEV，8.7％； BEV，13.8％；P = 0.21）和IE发作时的院内死亡（SEV，35.6％； BEV，37.7％；P = 0.74）相似组之间。在平均随访13±12个月后，分别有59.1％和54.6％的SEV和BEV接受者死亡（P= 0.66）。结论：TAVR后IE的特征因瓣膜类型而异，包括微生物类型，植被位置和栓塞并发症，但无早期或晚期死亡率。这些结果可能有助于指导IE的诊断和管理，并为该领域的未来研究提供参考。