Nationwide Registry‐Based Analysis of Infective Endocarditis Risk After Pulmonary Valve Replacement

Autor: Clara Stammnitz, Dörte Huscher, Ulrike M. M. Bauer, Aleksandra Urban, Johannes Nordmeyer, Stephan Schubert, Joachim Photiadis, Felix Berger, Sabine Klaassen
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 11, Iss 5 (2022)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.121.022231
Popis: Background Infective endocarditis (IE) after pulmonary valve replacements in congenital heart disease is a significant concern. This study aimed to identify specific long‐term risk factors for IE after percutaneous pulmonary valve implantation or surgical pulmonary valve replacement. Methods and Results All patients with congenital heart disease from the National Register for Congenital Heart Defects with at least 1 pulmonary valve replacement before January 2018 were included. A total of 1170 patients (56.3% men, median age at study inclusion 12 [interquartile range {Q1–Q3} 5–20 years]) received 1598 pulmonary valve replacements. IE occurred in 4.8% of patients during a follow‐up of total 9397 patient‐years (median 10 [Q1–Q3, 6–10] years per patient). After homograft implantation 7 of 558 (1.3%) patients developed IE, after heterograft implantation 31 of 723 (4.3%) patients, and after Melody valve implantation 18 of 241 (7.5%) patients. Edwards Sapien and mechanical valves were used less frequently and remained without IE. The incidence of IE in heterografts excluding Contegra valves was 7 of 278 (2.5%), whereas the incidence of IE in Contegra valves was 24 of 445 (5.4%). The risk of IE was not increased compared with homografts if Contegra valves were excluded from the heterografts (hazard ratio [HR], 2.60; P=0.075). The risk of IE was increased for bovine jugular vein valves, Contegra valves (HR, 6.72; P
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