The frequency and prognostic impact of fever following transcatheter aortic valve implantation

Cardiology. 2014;127(3):203-10. doi: 10.1159/000356940. Epub 2014 Jan 18.

Abstract

Objectives: This study sought to explore the frequency and prognostic implications of infectious and noninfectious fever following transcatheter aortic valve implantation (TAVI).

Methods: We performed a retrospective cohort study including 194 consecutive patients who underwent TAVI at our institution. We identified and characterized all patients who developed fever within the first 72 h following the procedure. We determined the etiology of the fevers (infectious vs. noninfectious) and assessed their impact on in-hospital complications and 1-year mortality.

Results: Following TAVI, 65 (33.5%) patients had fever (mean age 83.7 ± 3.8 years, 70.2% female). An infectious etiology was evident in only 17 of the 65 patients (26.1%) with fever, mainly due to pneumonia (52.9%) and a urinary tract infection (41.2%). No significant difference was observed in baseline characteristics, the mean fever temperature/duration, or signs of inflammatory response between infectious and noninfectious fevers. The mean hospital duration was longer (7 ± 4.8 days vs. 4.7 ± 2.4 days, p = 0.01) among patients with an infectious fever; however, fever had no impact on the 1-year mortality rate (5.9 and 4.5%, respectively, p = 0.71).

Conclusions: Our study demonstrates that, although fever was a common phenomenon after TAVI, it represented an infectious complication only in a minority of cases. Nevertheless, fever, infectious or not, had no impact on the 1-year mortality rate following TAVI.

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis / surgery*
  • Cardiac Catheterization / mortality*
  • Female
  • Fever / etiology*
  • Fever / mortality
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / mortality*
  • Humans
  • Length of Stay
  • Male
  • Pneumonia, Bacterial / etiology
  • Pneumonia, Bacterial / mortality
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / mortality