مختصر البحث:
Background: Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive
and effective alternative for treating severe aortic stenosis, particularly in high-risk
surgical patients. However, infective endocarditis following TAVI (PTIE) re…
Background: Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive
and effective alternative for treating severe aortic stenosis, particularly in high-risk
surgical patients. However, infective endocarditis following TAVI (PTIE) represents a
rare but serious complication with significant morbidity and mortality, compounded by
diagnostic delays and atypical clinical presentations. Objectives: This retrospective
cross-sectional study aimed to investigate the incidence, clinical features,
microbiological profile, diagnostic challenges, and short-term outcomes of PTIE, as well
as to identify predictors of poor prognosis. Methods: Data were collected from 599
patients who underwent TAVI between February 2021 and January 2025 at a specialised
cardiovascular centre. Patients diagnosed with PTIE according to the modified Duke
Criteria were analysed. Demographics, comorbidities, procedural details,
microbiological findings, imaging results, and clinical outcomes were recorded.
Statistical analyses included Chi-square tests, t-tests, and logistic regression to identify
independent predictors of in-hospital mortality. Results: Out of 599 patients, 27 (4.5%)
developed PTIE. The median time from TAVI to infection onset was 64 days. The most
common pathogens were Staphylococcus aureus (37%), Enterococcus faecalis (26%),
and Streptococcus species (15%). Culture-negative cases accounted for 22%.
Echocardiographic findings included prosthetic valve vegetations (59%), paravalvular
abscesses (15%), and valve dehiscence ( 7 % .) Short-term outcomes included in-hospital
mortality (25.9%), 30-day readmission (37%), and surgical intervention in 11.1%.
Independent predictors of in-hospital mortality included S. aureus infection (OR = 3.5, p
= 0.01), paravalvular abscess (OR = 4.2, p = 0.01), and diagnostic delay >7 days (OR =
5.1, p = 0.002). Conclusion: Although infrequent, PTIE carries a high risk of mortality
and diagnostic difficulty. Early identification of clinical warning signs, especially in
high-risk patients such as those with permanent pacemakers, chronic kidney disease, and
prolonged ICU stays, is crucial. Improved imaging
