TY - JOUR AU - Jiang, Weiwei AU - Wu, Wenconghui AU - Guo, Ruikang AU - Xie, Minghui AU - Yim, Wai Yen AU - Wang, Yin AU - Hu, Xingjian PY - 2021/02/10 Y2 - 2024/03/28 TI - Predictors of Prosthetic Valve Endocarditis following Transcatheter Aortic Valve Replacement: A Meta-Analysis JF - The Heart Surgery Forum JA - HSF VL - 24 IS - 1 SE - DO - 10.1532/hsf.3461 UR - https://journal.hsforum.com/index.php/HSF/article/view/3461 SP - E101-E107 AB - <p class="p1"><span class="s1"><strong>Background:</strong> Transcatheter aortic valve replacement (TAVR) has gained increasing acceptance for patients with aortic disease. A rare but fatal complication prosthetic valve endocarditis (PVE) could greatly influence the clinical outcomes of TAVR. This meta-analysis aims to pin down the predictors of PVE in TAVR patients. </span></p><p class="p1"><span class="s1"><strong>Methods:</strong> We performed a systematic search for studies that reported the incidence and risk factors of PVE after TAVR. Data on studies, patients, baseline characteristics, and procedural characteristics were abstracted. Crude risk ratios (RRs) and 95% confidence intervals for each predictor were calculated by the use of random-effects models. <br />Heterogeneity assumption was assessed by an I<sup>2</sup> test. </span></p><p class="p1"><span class="s2"><strong>Results:</strong> We obtained data from 8 studies that included 68,805 TAVR patients, of whom 1,256 (1.83%) were diagnosed with PVE after TAVR. 280 patients died within the 30-days of PVE diagnosis and the pooled in-hospital mortality was 22.3%. The summary estimates indicated an increased risk of PVE after TAVR for males (RR 1.53, <em>P</em> = .0001); for patients with orotracheal intubation (RR 1.65, <em>P</em> = .01), new pacemaker implantation (RR 1.46, <em>P</em> = .003), and residual aortic regurgitation (</span><span class="s3">≥</span><span class="s2">2 grade) (RR 1.62, <em>P</em> = .05); while older age (RR 0.97, <em>P</em> = .0007) and implantation of a self-expandable valve (RR 0.74, <em>P</em> = .02) were associated with a lower risk of PVE after TAVR. </span></p><p class="p1"><strong>Conclusion:</strong> Clinical characteristics and peri-<br />procedure factors including age, male sex, valve type, orotracheal intubation, pacemaker implantation, and residual regurgitation were proven to be associated with the occurrence of PVE-TAVR. Clinicians should pay particular attention to PVE when treating TAVR patients with these predictors.</p> ER -