{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:07:02Z","timestamp":1791446822563,"version":"4.3.3"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2019,12,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prosthetic valve endocarditis (PVE) is a rare but critical mechanism of valve failure and death after transcatheter and surgical aortic valve replacement (TAVR, SAVR) warranting further analysis in modern aortic valve replacement experience. We characterize the incidence, risk factors, microbiological profile and outcomes of PVE from the PARTNER trials and registries (Placement of Aortic Transcatheter Valve).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed a pooled cohort of all patients in PARTNER 1 and PARTNER 2 trials and registries. Patients had severe aortic stenosis, were treated with TAVR or SAVR, and were analyzed with respect to development of PVE. PVE adjudication by a clinical events committee was based on modified Duke Criteria. The incidence, infection timing, organism, and association between PVE and all-cause mortality were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      8530 patients were included. PVE occurred in 107 cases (5.06 PVE events per 1000 person-years over a mean follow-up of 2.69\u00b11.55 years [95% CI, 4.19\u20136.12]). The incidence of TAVR-PVE (5.21 PVE per 1000 person-years [95% CI, 4.26\u20136.38]) was not significantly different from SAVR-PVE (4.10 per 1000 person-years [95% CI, 2.33\u20137.22]; incident rate ratio, 1.27 [95% CI, 0.70\u20132.32];\n                      <jats:italic>P<\/jats:italic>\n                      =0.44). Temporal risk of PVE was similar for TAVR and SAVR, even after adjusting for competing risk of death (hazard ratio, 1.15 [95% CI, 0.58\u20132.28];\n                      <jats:italic>P<\/jats:italic>\n                      =0.69). Through multivariable analysis, PVE was associated with baseline cirrhosis (incident rate ratio, 2.86 [95% CI, 1.33\u20136.16];\n                      <jats:italic>P<\/jats:italic>\n                      =0.007), pulmonary disease (incident rate ratio, 1.70 [95% CI, 1.16\u20132.48];\n                      <jats:italic>P<\/jats:italic>\n                      =0.006), and renal insufficiency (incident rate ratio, 1.71 [95% CI, 1.03\u20132.83];\n                      <jats:italic>P<\/jats:italic>\n                      =0.04). Timing of PVE was similar between TAVR and SAVR (&lt;30 days: 4.2% vs 8.3%; 31 days to 1 year: 52.6% vs 66.7%; &gt;1 year: 43.2% vs 25.0%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.28). Staphylococcus occurred more commonly after SAVR (58.3% vs 28.4% in TAVR;\n                      <jats:italic>P<\/jats:italic>\n                      =0.04). PVE was strongly associated with all-cause mortality after endocarditis diagnosis (hazard ratio, 4.4 [95% CI, 3.42\u20135.72];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The widespread adoption of TAVR and application to lower-risk patients makes understanding mechanisms of valve failure increasingly important. PVE is an established mechanism of prosthetic valve failure post-SAVR and TAVR with unclear differences between approaches. We herein demonstrate in the largest trials and registries of TAVR that PVE remains rare, but often fatal, in modern AVR experience and that there is no difference in incidence, predictors, or risk of PVE between TAVR and SAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifiers: NCT00530894 (PARTNER 1), NCT01314313 (PARTNER 1IA), NCT02184442 (PARTNER 1IB), NCT03222141 (PII S3HR), NCT03222128 (PII S3i).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.119.041399","type":"journal-article","created":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T05:00:16Z","timestamp":1573016416000},"page":"1984-1994","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":113,"title":["Prosthetic Valve Endocarditis After TAVR and SAVR"],"prefix":"10.1161","volume":"140","author":[{"given":"Matthew R.","family":"Summers","sequence":"first","affiliation":[{"name":"Cleveland Clinic Foundation, OH (M.R.S., S.R.K., E.M.T., L.S., P.C.C., W.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin B.","family":"Leon","sequence":"additional","affiliation":[{"name":"Columbia University\/New York-Presbyterian Hospital, NY (M.B.L., C.R.S., S.K.K., M.C.A., R.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Columbia University\/New York-Presbyterian Hospital, NY (M.B.L., C.R.S., S.K.K., M.C.A., R.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susheel K.","family":"Kodali","sequence":"additional","affiliation":[{"name":"Columbia University\/New York-Presbyterian Hospital, NY (M.B.L., C.R.S., S.K.K., M.C.A., R.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod H.","family":"Thourani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Piedmont Heart Institute, Atlanta, GA (V.H.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard C.","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia (H.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj R.","family":"Makkar","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center, Los Angeles, CA (R.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Pibarot","sequence":"additional","affiliation":[{"name":"Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Canada (P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Webb","sequence":"additional","affiliation":[{"name":"University of British Columbia and St. Paul\u2019s Hospital, Vancouver, Canada (J.G.W., J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Leipsic","sequence":"additional","affiliation":[{"name":"University of British Columbia and St. Paul\u2019s Hospital, Vancouver, Canada (J.G.W., J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Alu","sequence":"additional","affiliation":[{"name":"Columbia University\/New York-Presbyterian Hospital, NY (M.B.L., C.R.S., S.K.K., M.C.A., R.T.H.)."},{"name":"Cardiovascular Research Foundation, New York, NY (M.C.A., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Crowley","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation, New York, NY (M.C.A., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca T.","family":"Hahn","sequence":"additional","affiliation":[{"name":"Columbia University\/New York-Presbyterian Hospital, NY (M.B.L., C.R.S., S.K.K., M.C.A., R.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir R.","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH (M.R.S., S.R.K., E.M.T., L.S., P.C.C., W.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Murat","family":"Tuzcu","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH (M.R.S., S.R.K., E.M.T., L.S., P.C.C., W.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Svensson","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH (M.R.S., S.R.K., E.M.T., L.S., P.C.C., W.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Cremer","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH (M.R.S., S.R.K., E.M.T., L.S., P.C.C., W.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael A.","family":"Jaber","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH (M.R.S., S.R.K., E.M.T., L.S., P.C.C., W.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60290-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60308-7"},{"key":"e_1_3_3_4_2","first-page":"388","article-title":"5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial.","volume":"385","author":"Leon MB","year":"2015","unstructured":"Leon, MB, Smith, CR, Miller, DC, Moses, JW, Tuzcu, EM, Webb, JG, Douglas, PS, Anderson, WN, Blackstone, EH, Kodali, SK, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. 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