Infective endocarditis following transcatheter edge-to-edge mitral valve repair: A systematic review
Lluis Asmarats MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorTania Rodriguez-Gabella MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorChekrallah Chamandi MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorMathieu Bernier MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorJonathan Beaudoin MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorKim O'Connor MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorEric Dumont MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorFrançois Dagenais MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorJean-Michel Paradis MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorCorresponding Author
Josep Rodés-Cabau MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Correspondence Josep Rodés-Cabau, MD, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. Email: [email protected]Search for more papers by this authorLluis Asmarats MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorTania Rodriguez-Gabella MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorChekrallah Chamandi MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorMathieu Bernier MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorJonathan Beaudoin MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorKim O'Connor MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorEric Dumont MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorFrançois Dagenais MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorJean-Michel Paradis MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Search for more papers by this authorCorresponding Author
Josep Rodés-Cabau MD
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Correspondence Josep Rodés-Cabau, MD, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. Email: [email protected]Search for more papers by this authorFunding information: Drs. Asmarats and Rodriguez-Gabella are supported by a research grant from the Fundación Alfonso Martín Escudero (Spain). Dr. Rodés-Cabau holds the Canadian Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions
Abstract
Objectives
To assess the clinical characteristics, management, and outcomes of patients diagnosed with infective endocarditis (IE) after edge-to-edge mitral valve repair with the MitraClip device.
Background
Transcatheter edge-to-edge mitral valve repair has emerged as an alternative to surgery in high-risk patients. However, few data exist on IE following transcatheter mitral procedures.
Methods
Four electronic databases (PubMed, Google Scholar, Embase, and Cochrane Library) were searched for original published studies on IE after edge-to-edge transcatheter mitral valve repair from 2003 to 2017.
Results
A total of 10 publications describing 12 patients with definitive IE (median age 76 years, 55% men) were found. The mean logistic EuroSCORE/EuroSCORE II were 41% and 45%, respectively. The IE episode occurred early (within 12 months post-procedure) in nine patients (75%; within the first month in five patients). Staphylococcus aureus was the most frequent (60%) causal microorganism, and severe mitral regurgitation was present in all cases but one. Surgical mitral valve replacement (SMVR) was performed in most (67%) patients, and the mortality associated with the IE episode was high (42%).
Conclusions
IE following transcatheter edge-to-edge mitral valve repair is a rare but life-threatening complication, usually necessitating SMVR despite the high-risk profile of the patients. These results highlight the importance of adequate preventive measures and a prompt diagnosis and treatment of this serious complication.
CONFLICT OF INTEREST
The authors do not report any conflict of interest with respect to the content of this article.
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