Efectividad del remplazo valvular aórtico vía transcatéter (TAVI) en la reducción del riesgo de endocarditis infecciosa en válvula protésica comparado con el remplazo valvular quirúrgico (SAVR): Revisión sistemática

Abstract

The interventional treatment of aortic stenosis is based on transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Infective endocarditis (IE) is a common complication after valve replacement, which has been associated with high mortality and morbidity. It has been suggested that TAVI reduces the risk of IE compared to SAVR due to its less invasive nature. Methods. A systematic review of observational studies and clinical trials was carried out to evaluate the efficacy of TAVI in reducing the risk of IE compared to SAVR. Results. Eight studies were selected. In total, 269.810 patients with severe symptomatic aortic stenosis were enrolled in the studies included, 91.270 of these underwent TAVI and 178.540 to SAVR. TAVI was not associated with statistically significant different risk of IE compared to with SAVR. The EI incidence after TAVI ranged between 0,0% - 1.86% per year, while in SAVR it was between 0.29% - 1.9% per year. The highest mortality reported after TAVI was 46.3% and in SAVR it reached 75%. Conclusions. According to the results, TAVI showed a similar risk of IE in both short and long-term following compared to SAVR.