Evidence map›Paper›PMID 40071261›Full record

ArticleLe infezioni in medicina2025

Post-procedural fever after Transcatheter Aortic Valve Implantation (TAVI). A multi-centric study.

Valentina Scheggi, Yohann Bohbot, Jasim Hasan, Pierre Vanhaecke, Stefano Del Pace, Carlo Fumagalli, Francesco Meucci, Giulia Nardi, Francesca Di Muro, Silvia Menale and 12 more

Abstract read
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Article in Le infezioni in medicina, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

22 authors.

Valentina ScheggiCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Yohann BohbotDepartment of Cardiology, Amiens University Hospital, Amiens, France.
Jasim HasanDepartment of Cardiology, Amiens University Hospital, Amiens, France.
Pierre VanhaeckeDepartment of Cardiology, Amiens University Hospital, Amiens, France.
Stefano Del PaceCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Carlo FumagalliDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Francesco MeucciCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Giulia NardiDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Francesca Di MuroDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Silvia MenaleDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Elena PisaniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Veronica VitielloDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Valeria SettiDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Nicola ZoppettiInstitute of Applied Physics "Nello Carrara" (IFAC), National Research Council, Sesto Fiorentino, Italy.
Renato ValentiCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Alfredo CerilloCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Pier Luigi StefànoCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Carlo Di MarioCardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.
Dan RusinaruDepartment of Cardiology, Amiens University Hospital, Amiens, France.
Anfani MirodeDepartment of Cardiology, Amiens University Hospital, Amiens, France.
Christophe TribouilloyDepartment of Cardiology, Amiens University Hospital, Amiens, France.
Niccolò MarchionniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Fever following transcatheter aortic valve implantation (TAVI) poses a clinical challenge, necessitating a comprehensive diagnostic approach to discern between infectious and non-infectious origins. Despite its minimally invasive nature, TAVI disrupts protective anatomical barriers, leading to an increased risk of infection, as well as to aseptic inflammatory responses. Standardized strategies for the management of these patients are lacking. Methods: We retrospectively analyzed 1074 consecutive patients. Data retrieved from electronic hospital charts included demographics, comorbidities, NYHA functional class, Multidimensional Prognostic Index (MPI), EUROSCORE II and STS risk score, pre- and post-procedural echocardiographic data, and procedural details. Fever was defined as temperature >37.5°C. Results: Overall, 391 patients (36.4%) experienced at least one episode of fever, in all cases ensuing within the first 2 days after the procedure. Fever lasted only one day (ODF) in most patients (86%). Antibiotic prophylaxis varied, with cefazolin showing the highest efficacy. Management of post-TAVI fever was heterogeneous. Twenty-five percent of febrile patients received an empiric antibiotic therapy, although a presumed site of infection was identified in only 17% of them and just 19 patients (4.9%) had positive blood cultures. Of the 19 patients with positive cultures, 11 had a Gram+ and 8 a Gram-infection. Fever duration, invasive accesses, and clinical suspicion of infection influenced antibiotic initiation. Fever lasting more than one day (MODF) was associated with new-onset atrial fibrillation and prolonged in-hospital stay. Positive blood cultures were linked to higher mortality, especially with Gram-bacteremia. However, patients with short-term fever had a similar mortality to those without fever, highlighting the benign nature of self-limited fever. Conclusions: Fever is a common complication after TAVI. A watchful waiting strategy is advisable in stable patients without evidence of infection and self-limited episodes of fever, while selected patients may benefit from an aggressive approach.

Indexed as

antibiotic prophylaxisfeverinfectionsPost-TAVI managementTranscatheter aortic valve implantation (TAVI)

Identifiers

PMID40071261
PMCPMC11892440

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