Risk of Infective Endocarditis Post-transcatheter Pulmonary Valve Replacement Versus Surgical Pulmonary Valve Replacement: A Systematic Review.

Ethan Slouha, Lashawnd L Johnson, Arani Thirunavukarasu, Hanin Al-Geizi, Lucy A Clunes, Theofanis F Kollias
Author Information
  1. Ethan Slouha: Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD.
  2. Lashawnd L Johnson: Pharmacology, St. George's University School of Medicine, St. George's, GRD.
  3. Arani Thirunavukarasu: Pharmacology, St. George's University School of Medicine, St. George's, GRD.
  4. Hanin Al-Geizi: Pharmacology, St. George's University School of Medicine, St. George's, GRD.
  5. Lucy A Clunes: Pharmacology, St George's University School of Medicine, St George's, GRD.
  6. Theofanis F Kollias: Microbiology, Immunology and Pharmacology, St. George's University School of Medicine, St. George's, GRD.

Abstract

Pulmonary valve replacement (PVR) is the most common cardiac operation in adult patients with congenital heart disease (ACHD). It can improve right ventricular outflow tract (RVOT) obstruction, typically due to pulmonary valve stenosis or regurgitation. PVR can be performed surgically (open-heart) and through a transcatheter (percutaneous) method, which is minimally invasive and is associated with shorter hospitalization stays. However, following PVR, infectious endocarditis (IE) can complicate the recovery process and increase mortality in the long term. IE is a rare but deadly multi-organ system condition caused by microorganisms traversing the bloodstream from a specific entry point. It can have many presentations, such as splinter hemorrhages, fevers, and vegetation on valves that lead to stroke consequences. This paper aims to evaluate the differences in the rate, etiology, manifestations, treatment, and outcomes of IE following surgical and transcatheter PVR, as the goal is to perform a procedure with few complications. In both approaches, was the most common microorganism that affected the valves, followed by . Research has shown that surgical pulmonary valve replacement (SPVR) has a decreased risk of IE following surgery compared to TPVR. However, TPVR is preferred due to the reduced overall risk and complications of the procedure. Despite this, the consensus on mortality rates does differ. Future research should consider the type of valves used for transcatheter pulmonary valve replacement (TPVR), such as Melody valves versus Edward Sapien valves, as their IE rates vary significantly.

Keywords

References

  1. Int J Cardiol. 2021 Jan 15;323:40-46 [PMID: 32860844]
  2. Int J Cardiol. 2018 Aug 15;265:47-51 [PMID: 29724567]
  3. Heart. 2015 May 15;101(10):788-93 [PMID: 25539944]
  4. Turk Gogus Kalp Damar Cerrahisi Derg. 2022 Jul 29;30(3):472-483 [PMID: 36303703]
  5. Cardiol J. 2021;28(4):566-578 [PMID: 34031866]
  6. Arch Cardiovasc Dis. 2018 Aug - Sep;111(8-9):497-506 [PMID: 29530718]
  7. J Am Heart Assoc. 2022 Mar;11(5):e022231 [PMID: 35179045]
  8. Arch Cardiovasc Dis. 2015 Feb;108(2):97-106 [PMID: 25445752]
  9. J Thorac Cardiovasc Surg. 2018 Aug;156(2):728-734.e2 [PMID: 29753513]
  10. Heart. 2002 Jul;88(1):61-6 [PMID: 12067947]
  11. Catheter Cardiovasc Interv. 2018 Feb 1;91(2):277-284 [PMID: 28895275]
  12. J Thorac Dis. 2019 Dec;11(12):5343-5351 [PMID: 32030252]
  13. J Thorac Cardiovasc Surg. 2014 Nov;148(5):2253-9 [PMID: 25218536]
  14. Heart Lung Circ. 2020 Dec;29(12):1799-1807 [PMID: 32616369]
  15. Methodist Debakey Cardiovasc J. 2019 Apr-Jun;15(2):122-132 [PMID: 31384375]
  16. J Infect Dis. 2002 Apr 1;185(7):994-7 [PMID: 11920326]
  17. BMJ. 2009 Jul 21;339:b2700 [PMID: 19622552]
  18. JACC Cardiovasc Interv. 2017 Mar 13;10(5):510-517 [PMID: 28279319]
  19. Cardiol Ther. 2012 Dec;1(1):5 [PMID: 25135159]
  20. Nat Rev Dis Primers. 2016 Sep 01;2:16059 [PMID: 27582414]
  21. Circ Cardiovasc Interv. 2013 Jun;6(3):292-300 [PMID: 23735475]
  22. J Cardiol. 2019 Sep;74(3):197-205 [PMID: 31113702]
  23. J Am Coll Cardiol. 2018 Dec 4;72(22):2717-2728 [PMID: 30497557]
  24. Cardiol Young. 2017 Mar;27(2):294-301 [PMID: 27161361]
  25. J Clin Med. 2021 Feb 13;10(4): [PMID: 33668597]
  26. Eur J Cardiothorac Surg. 2019 Jul 1;56(1):87-93 [PMID: 30698682]

Word Cloud

Created with Highcharts 10.0.0valvereplacementpulmonaryvalvesPVRcanIEPulmonarytranscatheterpercutaneousfollowingsurgicalTPVRcommondueHoweverendocarditismortalityprocedurecomplicationsriskratesValvecardiacoperationadultpatientscongenitalheartdiseaseACHDimproverightventricularoutflowtractRVOTobstructiontypicallystenosisregurgitationperformedsurgicallyopen-heartmethodminimallyinvasiveassociatedshorterhospitalizationstaysinfectiouscomplicaterecoveryprocessincreaselongtermIE israredeadlymulti-organsystemconditioncausedmicroorganismstraversingbloodstreamspecificentrypointmanypresentationssplinterhemorrhagesfeversvegetationleadstrokeconsequencespaperaimsevaluatedifferencesrateetiologymanifestationstreatmentoutcomesgoalperformapproachesmicroorganismaffectedfollowedResearchshownSPVRdecreasedsurgerycomparedpreferredreducedoverallDespiteconsensusdifferFutureresearchconsidertypeusedMelodyversusEdwardSapienvarysignificantlyRiskInfectiveEndocarditisPost-transcatheterReplacementVersusSurgicalReplacement:SystematicReviewinfectiveimplantation

Similar Articles

Cited By