A group of researchers aimed to compare the incidence and outcomes of IE after TAVR using a supra?annular, self?expanding platform (CoreValve and Evolut) to SAVR.
Three randomised clinical trials comparing TAVR to SAVR, as well as a prospective continuous TAVR access research, were pooled for their analysis. The modified Duke criteria was used to define IE. A total of 2249 patients were included in their study.
The cumulative incidence of IE was calculated using a cause-specific hazard model. The Kaplan–Meier method was used to determine all-cause mortality estimates. The valve implant cohort's outcomes were presented.
12 (0.5%) of 2249 patients underwent TAVR, and 21 (1.1%) of 1828 patients underwent SAVR had IE over a mean follow-up time of 2.171.51 years. Diabetes mellitus was more common in patients with IE than in those without (57.6% versus 34.2 %; P=0.005).
At one year, the rate of all-cause death in patients with IE was 27.3% (95 % CI, 1.0 %–53.6 %) in the TAVR group and 51.8 % (95 % CI, 28.2 % –75.3 %) in the SAVR group (logrank P=0.15).
After 5 years, the cumulative incidence of IE following TAVR was 1.01 % (95% CI, 0.47 % –1.96 %) and 1.58 % (95 % CI, 0.97 % –2.46 %) (P=0.047).
The study's authors concluded that TAVR with a supra-annular, self-expanding device was found to have a low cumulative incidence of IE regardless of treatment mode, although its risk was lower in the TAVR implant group. Once IE occurred, the death rate was increased.