HENRIQUE BARBOSA RIBEIRO

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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Colaboração internacional: Canadá × Colaboração internacional: Estados Unidos ×

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  • conferenceObject
    IMPACT OF MORBID OBESITY AND OBESITY PHENOTYPE ON OUTCOMES POST TRANSCATHETER AORTIC VALVE REPLACEMENT
    (2020) MCINERNEY, A.; TIRADO-CONTE, G.; RODES-CABAU, J.; CAMPELO-PARADA, F.; SOTO, J. D. Tafur; BARBANTI, M.; MUNOZ-GARCIA, E.; ARIF, M.; LOPEZ, D.; TOGGWEILER, S.; VEIGA, G.; PYLKO, A.; SEVILLA, T.; COMPAGNONE, M.; REGUEIRO, A.; SERRA, V.; CARNERO, M.; OTEO, J. F.; RIVERO, F.; RIBEIRO, H. Barbosa; GUIMARAES, L.; MATTA, A.; ECHAVARRIA, N. Giraldo; VALVO, R.; MOCCETTI, F.; MUNOZ-GARCIA, A. J.; LOPEZ-PAIS, J.; BLANCO, B. Garcia del; BORGES, D. Carter Campanha; GONZALO, N.; DUMONT, E.; CRISCIONE, E.; DABROWSKI, M.; ALFONSO, F.; HERNANDEZ, J. M. de la Torre; CHEEMA, A. N.; AMAT-SANTOS, I.; SAIA, F.; ESCANED, J.; NOMBELA-FRANCO, L.
  • article 27 Citação(ões) na Scopus
    Valve-in-Valve Challenges: How to Avoid Coronary Obstruction
    (2019) BERNARDI, Fernando L. M.; DVIR, Danny; RODES-CABAU, Josep; RIBEIRO, Henrique B.
    Coronary obstruction is a rare but life-threatening complication in patients undergoing transcatheter aortic valve replacement (TAVR). Aortic valve-in-valve (VIV) procedures to treat failed surgical bioprosthesis is associated with similar to 6-fold higher risk for coronary obstruction in certain situations. The primary mechanism consists in the occlusion of the coronary ostium by the dislodged leaflet from the bioprosthesis after deployment of the transcatheter heart valve (THV), which most commonly occurs during the index procedure, but in up to 1/3 of cases a delayed presentation ensues. The clinical presentation consists of severe hypotension and ECG changes in most of the patients, with very high mortality rates. Therefore, pre-procedural multi-slice computed tomography is crucial for identifying high-risk features, such as low coronary heights, shallow sinuses of Valsalva, and short virtual THV to coronary ostial distance (VTC). Also, some models of surgical bioprosthesis present an increased risk for this dreadful complication. Preemptive protective strategies with coronary wiring, with or without placement of an undeployed stent, could mitigate the risks associated with this complication in high-risk patients, even though studies are lacking. This review aims to take a clinical perspective on the challenges in avoiding this complication during VIV procedures.
  • article 103 Citação(ões) na Scopus
    Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry
    (2021) SIMONATO, Matheus; WHISENANT, Brian; RIBEIRO, Henrique Barbosa; WEBB, John G.; KORNOWSKI, Ran; GUERRERO, Mayra; WIJEYSUNDERA, Harindra; SONDERGAARD, Lars; BACKER, Ole De; VILLABLANCA, Pedro; RIHAL, Charanjit; ELEID, Mackram; KEMPFERT, Jorg; UNBEHAUN, Axel; ERLEBACH, Magdalena; CASSELMAN, Filip; ADAM, Matti; MONTORFANO, Matteo; ANCONA, Marco; SAIA, Francesco; UBBEN, Timm; MEINCKE, Felix; NAPODANO, Massimo; CODNER, Pablo; SCHOFER, Joachim; PELLETIER, Marc; CHEUNG, Anson; SHUVY, Mony; PALMA, Jose Honorio; GAIA, Diego Felipe; DUNCAN, Alison; HILDICK-SMITH, David; VEULEMANS, Verena; SINNING, Jan-Malte; ARBEL, Yaron; TESTA, Luca; WEGER, Arend de; ELTCHANINOFF, Helene; HEMERY, Thibault; LANDES, Uri; TCHETCHE, Didier; DUMONTEIL, Nicolas; RODES-CABAU, Josep; KIM, Won-Keun; SPARGIAS, Konstantinos; KOURKOVELI, Panagiota; BEN-YEHUDA, Ori; TELES, Rui Campante; BARBANTI, Marco; FIORINA, Claudia; THUKKANI, Arun; MACKENSEN, G. Burkhard; JONES, Noah; PRESBITERO, Patrizia; PETRONIO, Anna Sonia; ALLALI, Abdelhakim; CHAMPAGNAC, Didier; BLEIZIFFER, Sabine; RUDOLPH, Tanja; IADANZA, Alessandro; SALIZZONI, Stefano; AGRIFOGLIO, Marco; NOMBELA-FRANCO, Luis; BONAROS, Nikolaos; KASS, Malek; BRUSCHI, Giuseppe; AMABILE, Nicolas; CHHATRIWALLA, Adnan; MESSINA, Antonio; HIRJI, Sameer A.; ANDREAS, Martin; WELSH, Robert; SCHOELS, Wolfgang; HELLIG, Farrel; WINDECKER, Stephan; STORTECKY, Stefan; MAISANO, Francesco; STONE, Gregg W.; DVIR, Danny
    Background: Mitral valve-in-valve (ViV) and valve-in-ring (ViR) are alternatives to surgical reoperation in patients with recurrent mitral valve failure after previous surgical valve repair or replacement. Our aim was to perform a large-scale analysis examining midterm outcomes after mitral ViV and ViR. Methods: Patients undergoing mitral ViV and ViR were enrolled in the Valve-in-Valve International Data Registry. Cases were performed between March 2006 and March 2020. Clinical endpoints are reported according to the Mitral Valve Academic Research Consortium (MVARC) definitions. Significant residual mitral stenosis (MS) was defined as mean gradient >= 10 mm Hg and significant residual mitral regurgitation (MR) as >= moderate. Results: A total of 1079 patients (857 ViV, 222 ViR; mean age 73.5 +/- 12.5 years; 40.8% male) from 90 centers were included. Median STS-PROM score 8.6%; median clinical follow-up 492 days (interquartile range, 76-996); median echocardiographic follow-up for patients that survived 1 year was 772.5 days (interquartile range, 510-1211.75). Four-year Kaplan-Meier survival rate was 62.5% in ViV versus 49.5% for ViR (P<0.001). Mean gradient across the mitral valve postprocedure was 5.7 +/- 2.8 mm Hg (>= 5 mm Hg; 61.4% of patients). Significant residual MS occurred in 8.2% of the ViV and 12.0% of the ViR patients (P=0.09). Significant residual MR was more common in ViR patients (16.6% versus 3.1%; P<0.001) and was associated with lower survival at 4 years (35.1% versus 61.6%; P=0.02). The rates of Mitral Valve Academic Research Consortium-defined device success were low for both procedures (39.4% total; 32.0% ViR versus 41.3% ViV; P=0.01), mostly related to having postprocedural mean gradient >= 5 mm Hg. Correlates for residual MS were smaller true internal diameter, younger age, and larger body mass index. The only correlate for residual MR was ViR. Significant residual MS (subhazard ratio, 4.67; 95% CI, 1.74-12.56; P=0.002) and significant residual MR (subhazard ratio, 7.88; 95% CI, 2.88-21.53; P<0.001) were both independently associated with repeat mitral valve replacement. Conclusions: Significant residual MS and/or MR were not infrequent after mitral ViV and ViR procedures and were both associated with a need for repeat valve replacement. Strategies to improve postprocedural hemodynamics in mitral ViV and ViR should be further explored.
  • article
    Novel strategies in aortic valve-in-valve therapy including bioprosthetic valve fracture and BASILICA
    (2018) DVIR, Danny; KHAN, Jaffar; KORNOWSKI, Ran; KOMATSU, Ikki; CHHATRIWALLA, Adnan; MACKENSEN, G. Burkhard; SIMONATO, Matheus; RIBEIRO, Henrique; WOOD, David; LEIPSIC, Jonathon; WEBB, John; MYLOTTE, Darren
    An ageing population and increased utilisation of tissue valves in younger patients imply that the number of patients receiving transcatheter aortic valve implantation within failed bioprostheses will continue to increase. There are two major adverse events associated with aortic valve-in-valve procedures that may temper the enthusiasm for these appealing interventions. Residual stenosis is the ""Achilles' heel"" of aortic valve-in-valve, while coronary obstruction is an uncommon but life-threatening adverse event. Prevention of these adverse events is essential. Emerging tools and techniques enable operators to manipulate existing devices and to implant new ones inside them safely. Considering the available evidence, it seems that bioprosthetic valve ring fracture and bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) may enable some solution. Until we have prosthetic valves that are both very durable and non-thrombogenic, we can expect that techniques and tools chosen to treat failed bioprosthetic valves effectively will continue to be designed and utilised.
  • article 2 Citação(ões) na Scopus
    Usefulness of the B-Type Natriuretic Peptides in Low Ejection Fraction, Low-Flow, Low-Gradient Aortic Stenosis Results from the TOPAS Multicenter Prospective Cohort Study
    (2021) ANNABI, Mohamed-Salah; ZHANG, Bin; BERGLER-KLEIN, Jutta; DAHOU, Abdellaziz; BURWASH, Ian G.; GUZZETTI, Ezequiel; ONG, Geraldine; TASTET, Lionel; ORWAT, Stefan; BAUMGARTNER, Helmut; BARTKO, Philipp E.; KOSCHUTNIK, Matthias; MASCHERBAUER, Julia; MUNDIGLER, Gerald; CAVALCANTE, Joao; RIBEIRO, Henrique B.; RODES-CABAU, Josep; PIBAROT, Philippe; CLAVEL, Marie-Annick
    Background: Patients with low left ventricular ejection fraction (LVEF), low-flow, low-gradient (i.e. classical low flow [CLF]) aortic stenosis (AS) have a dismal short-term outcome without aortic valve replacement (AVR) but high operative mortality. We hypothesized that brain natriuretic peptides (BNP/NT-proBNP) can risk stratify patients with CLF AS and may assist in clinical decision-making. Methods: Patients with aortic valve area <= 1.2 cm(2), mean transvalvular gradient <40 mmHg, and left ventricular ejection fraction <50%, were prospectively recruited. BNP and/or NT-proBNP were measured at baseline. Results: Among 234 patients (77 [68-83] years, 76% male), BNP > 550 pg/ml or NT-proBNP > 1,600 pg/ml (85% and 93% sensitivity, respectively, to correctly classify 1-year death) strongly predicted all-cause mortality (adjusted HR = 2.53 [1.68-3.81], p < 0.001) outperforming flow reserve and baseline LVEF (all likelihood ratio p <= 0.02). For both natriuretic peptides, spline curve analysis showed gradual increase in mortality with higher biomarkers levels, which was blunted by AVR. In a head-to-head comparison (n = 104), NT-proBNP appeared to have superior incremental prognostic value than BNP (likelihood-ratio p p = 0.07). Baseline NT-proBNP >= 1,600 pg/ml or BNP >= 550 pg/ml, identified: i) a high-risk cohort with a dismal outcome under conservative management, but a markedly better survival associated with early AVR (adjusted HR = 0.41 [0.25-0.65], p < 0.001); and ii) a low-risk cohort with an excellent 1-year survival (94 +/- 4%) with conservative management or deferred AVR. Conclusion: In patients with CLF AS, BNP/NT-proBNP have the potential to identify high-risk patients who may benefit from early AVR.
  • article 20 Citação(ões) na Scopus
    Permanent Pacemaker Implantation Following Valve-in-Valve Transcatheter Aortic Valve Replacement
    (2021) ALPERI, Alberto; RODES-CABAU, Josep; SIMONATO, Matheus; TCHETCHE, Didier; CHARBONNIER, Gaetan; RIBEIRO, Henrique B.; LATIB, Azeem; MONTORFANO, Matteo; BARBANTI, Marco; BLEIZIFFER, Sabine; REDFORS, Bjorn; ABDEL-WAHAB, Mohamed; ALLALI, Abdelhakim; BRUSCHI, Giuseppe; NAPODANO, Massimo; AGRIFOGLIO, Marco; PETRONIO, Anna Sonia; GIANNINI, Cristina; CHAN, Albert; KORNOWSKI, Ran; PRAVDA, Nili Schamroth; ADAM, Matti; IADANZA, Alessandro; NOBLE, Stephane; CHATFIELD, Andrew; ERLEBACH, Magdalena; KEMPFERT, Joerg; UBBEN, Timm; WIJEYSUNDERA, Harindra; SEIFFERT, Moritz; PILGRIM, Thomas; KIM, Won-Keun; TESTA, Luca; HILDICK-SMITH, David; NERLA, Roberto; FIORINA, Claudia; BRINKMANN, Christina; CONZELMANN, Lars; CHAMPAGNAC, Didier; SAIA, Francesco; NISSEN, Henrik; AMRANE, Hafid; WHISENANT, Brian; SHAMEKHI, Jasmin; SONDERGAARD, Lars; WEBB, John G.; DVIR, Danny
    BACKGROUND Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs). OBJECTIVES The goal of this study was to determine the incidence, factors associated with, and clinical impact of PPI in a large series of ViV-TAVR procedures. METHODS Data were obtained from the multicenter VIVID Registry and included the main baseline and procedural characteristics, in-hospital and late (median follow-up: 13 months [interquartile range: 3 to 41 months]) outcomes analyzed according to the need of periprocedural PPI. All THVs except CoreValve, Cribier-Edwards, Sapien, and Sapien XT were considered to be new-generation THVs. RESULTS A total of 1,987 patients without prior PPI undergoing ViV-TAVR from 2007 to 2020 were included. Of these, 128 patients (6.4%) had PPI after TAVR, with a significant decrease in the incidence of PPI with the use of new-generation THVs (4.7% vs. 7.4%; p = 0.017), mainly related to a reduced PPI rate with the Evolut R/Pro versus CoreValve (3.7% vs. 9.0%; p = 0.002). There were no significant differences in PPI rates between newer-generation balloon-and self expanding THVs (6.1% vs. 3.9%; p = 0.18). In the multivariable analysis, older age (odds ratio [OR]: 1.05 for each increase of 1 year; 95% confidence interval [CI]: 1.02 to 1.07; p = 0.001), larger THV size (OR: 1.10; 95% CI: 1.01 to 1.20; p = 0.02), and previous right bundle branch block (OR: 2.04; 95% CI: 1.00 to 4.17; p = 0.05) were associated with an increased risk of PPI. There were no differences in 30-day mortality between the PPI (4.7%) and no-PPI (2.7%) groups (p = 0.19), but PPI patients exhibited a trend toward higher mortality risk at follow-up (hazard ratio: 1.39; 95% CI: 1.02 to 1.91; p = 0.04; p = 0.08 after adjusting for age differences between groups). CONCLUSIONS In a contemporary large series of ViV-TAVR patients, the rate of periprocedural PPI was relatively low, and its incidence decreased with the use of new-generation THV systems. PPI following ViV-TAVR was associated with a trend toward increased mortality at follow-up. (J Am Coll Cardiol 2021;77:2263 & ndash;73) (c) 2021 by the American College of Cardiology Foundation.
  • article 276 Citação(ões) na Scopus
    Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry
    (2018) RIBEIRO, Henrique B.; RODES-CABAU, Josep; BLANKE, Philipp; LEIPSIC, Jonathon; PARK, Jong Kwan; BAPAT, Vinayak; MAKKAR, Raj; SIMONATO, Matheus; BARBANTI, Marco; SCHOFER, Joachim; BLEIZIFFER, Sabine; LATIB, Azeem; HILDICK-SMITH, David; PRESBITERO, Patrizia; WINDECKER, Stephan; NAPODANO, Massimo; CERILLO, Alfredo G.; ABDEL-WAHAB, Mohamed; TCHETCHE, Didier; FIORINA, Claudia; SINNING, Jan-Malte; COHEN, Mauricio G.; GUERRERO, Mayra E.; WHISENANT, Brian; NIETLISPACH, Fabian; PALMA, Jose Honorio; NOMBELA-FRANCO, Luis; WEGER, Arend de; KASS, Malek; BRITO JR., Fabio Sandoli de; LEMOS, Pedro A.; KORNOWSKI, Ran; WEBB, John; DVIR, Danny
    Aims There are limited data on coronary obstruction following transcatheter valve-in-valve (ViV) implantation inside failed aortic bioprostheses. The objectives of this study were to determine the incidence, predictors, and clinical outcomes of coronary obstruction in transcatheter ViV procedures. Methods and results A total of 1612 aortic procedures from the Valve-in-Valve International Data (VIVID) Registry were evaluated. Data were subject to centralized blinded corelab computed tomography (CT) analysis in a subset of patients. The virtual transcatheter valve to coronary ostium distance (VTC) was determined. A total of 37 patients (2.3%) had clinically evident coronary obstruction. Baseline clinical characteristics in the coronary obstruction patients were similar to controls. Coronary obstruction was more common in stented bioprostheses with externally mounted leaflets or stentless bioprostheses than in stented with internally mounted leaflets bioprostheses (6.1% vs. 3.7% vs. 0.8%, respectively; P < 0.001). CT measurements were obtained in 20 (54%) and 90 (5.4%) of patients with and without coronary obstruction, respectively. VTC distance was shorter in coronary obstruction patients in relation to controls (3.24 +/- 2.22 vs. 6.30 +/- 2.34, respectively; P < 0.001). Using multivariable analysis, the use of a stentless or stented bioprosthesis with externally mounted leaflets [odds ratio (OR): 7.67; 95% confidence interval (CI): 3.14-18.7; P < 0.001] associated with coronary obstruction for the global population. In a second model with CT data, a shorter VTC distance predicted this complication (OR: 0.22 per 1mm increase; 95% CI: 0.09-0.51; P < 0.001), with an optimal cut-off level of 4mm (area under the curve: 0.943; P < 0.001). Coronary obstruction was associated with a high 30-day mortality (52.9% vs. 3.9% in the controls, respectively; P < 0.001). Conclusion Coronary obstruction following aortic ViV procedures is a life-threatening complication that occurred more frequently in patients with prior stentless or stented bioprostheses with externally mounted leaflets and in those with a short VTC.
  • article 1 Citação(ões) na Scopus
    Recent Developments and Current Status of Transcatheter Aortic Valve Replacement Practice in Latin America - the WRITTEN LATAM Study
    (2022) BERNARDI, Fernando Luiz de Melo; RIBEIRO, Henrique Barbosa; NOMBELA-FRANCO, Luis; CERRATO, Enrico; MALUENDA, Gabriel; NAZIF, Tamim; LEMOS, Pedro Alves; SZTEJFMAN, Matias; LAMELAS, Pablo; ECHEVERRI, Dario; LOPES, Marcelo Antonio Cartaxo Queiroga; BRITO, Fabio Sandoli de; ABIZAID, Alexandre A.; MANGIONE, Jose A.; ELTCHANINOFF, Helene; SONDERGAARD, Lars; RODES-CABAU, Josep
    Background: Transcatheter aortic valve replacement (TAVR) is a worldwide adopted procedure with rapidly evolving practices. Regional and temporal variations are expected to be found. Objective: To compare TAVR practice in Latin America with that around the world and to assess its changes in Latin America from 2015 to 2020. Methods: A survey was applied to global TAVR centers between March and September 2015, and again to Latin-American centers between July 2019 and January 2020. The survey consisted of questions addressing: i) center's general information; ii) pre-TAVR evaluation; iii) procedural techniques; iv) post-TAVR management; v) follow-up. Answers from the 2015 survey of Latin-American centers (LATAM15) were compared with those of other centers around the world (WORLD15) and with the 2020 updated Latin-American survey (LATAM20). A 5% level of significance was adopted for statistical analysis. Results: 250 centers participated in the 2015 survey (LATAM15=29; WORLD15=221) and 46 in the LATAM20. Combined centers experience accounted for 73 707 procedures, with WORLD15 centers performing, on average, 6- and 3-times more procedures than LATAM15 and LATAM20 centers, respectively. LATAM centers performed less minimalistic TAVR than WORLD15 centers, but there was a significant increase in less invasive procedures after 5 years in Latin-American centers. For postprocedural care, a lower period of telemetry and maintenance of temporary pacing wire, along with less utilization of dual antiplatelet therapy was observed in LATAM20 centers. Conclusion: Despite still having a much lower volume of procedures, many aspects of TAVR practice in Latin-American centers have evolved in recent years, following the trend observed in developed country centers.
  • conferenceObject
    Impact of left ventricular fibrosis and longitudinal systolic strain on outcomes in low gradient aortic stenosis
    (2021) FUKUI, M.; ANNABI, M. S.; ROSA, V. E. E.; RIBEIRO, H. B.; TARASOUTCHI, F.; SHELBERT, E. B.; BERGLER-KLEIN, J.; MASCHERBAUER, J.; ROCHITTE, C. E.; PIBAROT, P.; CAVALCANTE, J. L.
  • article 9 Citação(ões) na Scopus
    Infective Endocarditis Caused by Staphylococcus aureus After Transcatheter Aortic Valve Replacement
    (2022) VAL, David del; ABDEL-WAHAB, Mohamed; MANGNER, Norman; DURAND, Eric; IHLEMANN, Nikolaj; URENA, Marina; PELLEGRINI, Costanza; GIANNINI, Francesco; GASIOR, Tomasz; WOJAKOWSKI, Wojtek; LANDT, Martin; AUFFRET, Vincent; SINNING, Jan Malte; CHEEMA, Asim N.; NOMBELA-FRANCO, Luis; CHAMANDI, Chekrallah; CAMPELO-PARADA, Francisco; MUNOZ-GARCIA, Erika; HERRMANN, Howard C.; TESTA, Luca; WON-KEUN, K.; CASTILLO, Juan Carlos; ALPERI, Alberto; TCHETCHE, Didier; BARTORELLI, Antonio L.; KAPADIA, Samir; STORTECKY, Stefan; AMAT-SANTOS, Ignacio; WIJEYSUNDERA, Harindra C.; LISKO, John; GUTIERREZ-IBANES, Enrique; SERRA, Vicenc; SALIDO, Luisa; ALKHODAIR, Abdullah; VENDRAMIN, Igor; CHAKRAVARTY, Tarun; LERAKIS, Stamatios; VILALTA, Victoria; REGUEIRO, Ander; ROMAGUERA, Rafael; KAPPERT, Utz; BARBANTI, Marco; MASSON, Jean-Bernard; MAES, Frederic; FIORINA, Claudia; MICELI, Antonio; KODALI, Susheel; RIBEIRO, Henrique B.; MANGIONE, Jose Armando; JR, Fabio Sandoli de Brito; DATO, Guglielmo Mario Actis; ROSATO, Francesco; FERREIRA, Maria-Cristina; LIMA, Valter Corriea de; COLAFRANCESCHI, Alexandre Siciliano; ABIZAID, Alexandre; MARINO, Marcos Antonio; ESTEVES, Vinicius; ANDREA, Julio; GODINHO, Roger R.; ALFONSO, Fernando; ELTCHANINOFF, Helene; SONDERGAARD, Lars; HIMBERT, Dominique; HUSSER, Oliver; LATIB, Azeem; BRETON, Herve Le; SERVOZ, Clement; PASCUAL, Isaac; SIDDIQUI, Saif; OLIVARES, Paolo; HERNANDEZ-ANTOLIN, Rosana; WEBB, John G.; SPONGA, Sandro; MAKKAR, Raj; KINI, Annapoorna S.; BOUKHRIS, Marouane; GERVAIS, Philippe; LINKE, Axel; CRUSIUS, Lisa; HOLZHEY, David; RODES-CABAU, Josep
    Background: Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Methods: Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. Results: SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if > 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). Conclusions: SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.