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首页> 外文期刊>EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology >Prosthetic valve endocarditis after transcatheter aortic valve implantation: The incidence in a single-centre cohort and reflections on clinical, echocardiographic and prognostic features
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Prosthetic valve endocarditis after transcatheter aortic valve implantation: The incidence in a single-centre cohort and reflections on clinical, echocardiographic and prognostic features

机译：经导管主动脉瓣植入术后人工瓣膜心内膜炎：单中心队列的发生率以及对临床，超声心动图和预后特征的思考

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Aims: Transcatheter aortic valve implantation (TAVI) has recently developed into an accepted alternative to conventional surgery in high-risk patients. According to current data, post-TAVI prosthetic valve endocarditis (PVE) seems to occur very rarely. Methods and results: We followed the first 180 consecutive patients who underwent TAVI at our institution to assess safety and efficacy of the procedure. During follow-up (median, 319 days), PVE was seen more frequently than expected. By applying modified Duke criteria five cases could be confirmed (four early-onset and one late-onset PVE, four cases with "definite diagnosis" and one with "possible diagnosis") representing an estimated PVE incidence of 3.4% at one year. Two patients died subsequently. Clinical summaries of all cases are reported and compared to previously published case reports. Conclusions: According to our hypothesis, PVE might be particularly difficult to diagnose after TAVI, whereas TAVI-specific elderly patients might be exceptionally vulnerable. There exists little experience of TEE interpretation in post-TAVI endocarditis which should possess unique characteristics regarding, e.g., valve dehiscence or abscess formation. Therefore, echocardiography as a diagnostic tool often remains initially inconclusive. Because of incongruence between prosthetic device and calcified native aortic valve, some degree of paravalvular leak is common after TAVI. These paravalvular leaks as a nidus for infection, advanced age and abundant comorbidities might predispose TAVI patients for infective endocarditis.
机译：目的：经导管主动脉瓣植入术（TAVI）最近已发展成为高危患者常规手术的公认替代方法。根据目前的数据，TAVI人工瓣膜后心内膜炎（PVE）似乎很少发生。方法和结果：我们追踪了在本机构接受TAVI的前180名连续患者，以评估该过程的安全性和有效性。在随访期间（中位数319天），发现PVE的频率高于预期。通过应用改良的Duke标准，可以确认5例病例（4例早发和1例晚发PVE，4例“明确诊断”和1例“可能诊断”），估计一年中PVE发生率为3.4％。随后有两名患者死亡。报告所有病例的临床总结，并将其与以前发表的病例报告进行比较。结论：根据我们的假设，PVE在TAVI后可能尤其难以诊断，而TAVI特异性的老年患者可能格外脆弱。在TAVI后心内膜炎中，TEE解释的经验很少，应具有独特的特征，例如瓣膜裂开或脓肿形成。因此，超声心动图作为诊断工具通常在开始时尚无定论。由于假体与钙化的主动脉瓣膜之间的不一致，TAVI后常见一定程度的瓣周漏。这些瓣周漏是感染，高龄和大量合并症的病因，可能使TAVI患者容易感染传染性心内膜炎。

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