Impact of Preoperative Dental Screening in Reducing Infective Endocarditis Risk in Transcatheter Aortic Valve Implantation Patients

Infective endocarditis (IE), a condition linked with significant mortality and morbidity rates, is particularly concerning for patients with prosthetic left-sided valves.

These patients face an elevated IE risk, estimated at about 1% annually in tertiary care settings, cumulatively impacting around one in every 20 patients over a decade.

In line with this, both the American Heart Association (AHA) and the European Society of Cardiology (ESC) strongly advocate for the elimination of potential dental sepsis sources at least two weeks before prosthetic valve implantation, except in urgent cases.

These guidelines, while not grounded in randomized trials, largely draw upon registry data detailing IE incidence among surgical aortic valve replacement (SAVR) patients.

In a recent study the investigators found no difference in risk of IE when comparing mandatory preoperative dental screening (MPDS) with no preoperative dental screening (NPDS).

Thus, this prospective registry-based observational before-and-after study aims to investigate the impact of different preoperative dental screening practices on the risk of IE in patients undergoing.

• No preoperative dental screening (Procedure): Discontinuance of mandatory preoperative dental screening prior TAVI which also can include oral surgery.

Primary outcomes

• Number of Participants with Infectious Endocarditis [Through study completion, an average of 1 year]: Infectious endocarditis diagnosed by healthcare professionals

Secondary outcomes

• Number of Participants undergoing Oral surgical procedure at dental screening [Through study completion, an average of 1 year]: Number of oral surgical procedure performed in patients as part of the dental screening
• Number of Participants undergoing Tooth extraction at dental screening [Through study completion, an average of 1 year]: Number of Tooth extraction procedure performed in patients as part of the dental screening
• The different Bacteria types causing the infectious endocarditis assessed by blood culture [Through study completion, an average of 1 year]: Reporting all the different bacteria type causing infectious endocarditis, including the rate of each bacteria.
• Number patients with Bacteremia assessed by positive blood culture [Through study completion, an average of 1 year]: Cases of bacteremia in the population.
• Number of Participants with IE caused by bacteria from oral foci [Through study completion, an average of 1 year]: Infectious Endocarditis caused by bacteria from oral foci
• Number of Participants with Cardiac implantable electronic device risk of IE [Through study completion, an average of 1 year]: Cardiac implantable electronic device risk of IE

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Patients undergoing TAVI

Exclusion Criteria:

* None

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• Jordi S Dahl, MD,PhD,DMSc, Principal investigator, Odense University Hospital