Outcomes of Treatment for Infective Endocarditis Following Transcatheter Pulmonary Valve Replacement

J. Chancellor Fox, Horacio G. Carvajal, Fei Wan, Matthew W. Canter, Taylor C. Merritt, Pirooz Eghtesady

Research output: Contribution to journalArticlepeer-review


Background: Recipients of transcatheter pulmonary valve replacement (TPVR) have shown increased risk of infective endocarditis (IE). Little is known about the outcomes of different management strategies, particularly surgery, for IE after TPVR. Methods: We queried the Pediatric Health Information System database for cases of IE after TPVR performed from 2010-2020. We described patient demographics, hospital courses, admission complications, and treatment outcomes based on therapy offered, surgical or medical only. We compared outcomes of initial therapy. Data are expressed as median or percent. Results: Sixty-nine cases of IE were identified, accounting for 98 related hospital admissions; 29% of patients recorded IE-related readmissions. Of those readmitted after initial medical therapy only, 33% had relapse IE. Rates of surgery were 22% during initial admission and 36% overall. Likelihood of surgical intervention increased with each subsequent admission. Renal and respiratory failure were more common in those given initial surgery. Mortality rate was 4.3% overall and 8% in the surgical cohort. Conclusion: Initial medical therapy may result in relapses/readmissions and possible delay of surgical therapy, which appears to be most effective for treatment of IE. For those treated only medically, a more aggressive course of therapy may be more likely to prevent relapse. Mortality following surgical therapy for IE after TPVR appears higher than reported for surgical pulmonary valve replacement generally.

Original languageEnglish
Pages (from-to)12-20
Number of pages9
JournalWorld Journal for Pediatric and Congenital Heart Surgery
Issue number1
StatePublished - Jan 2023


  • congenital heart disease
  • endocarditis
  • heart valve bioprosthesis
  • infection
  • pulmonary valve


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