Outcomes and Effects of Hepatic Cirrhosis in Patients Who Underwent Transcatheter Aortic Valve Implantation

Yassin, Ahmed; Subahi, Ahmed; Abubakar, Hossam; Akintoye, Emmanuel; Rashid, Asif; Adegbala, Oluwole; Ahmed, Abdelrahman; Elmoughrabi, Adel; Subahi, Eihab A; Pahuja, Mohit; Sahlieh, Ali; Elder, Mahir; Kaki, Amir; Schreiber, Theodore; Mohamad, Tamam

doi:10.1016/j.amjcard.2018.04.013

Cited by 10 publications

(14 citation statements)

References 17 publications

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“…In 2018, Yassin et al showed that mortality was not statistically different between cirrhotic patients and other patients undergoing TAVR procedure (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.59 to 2.10, P = .734). 18 Hemorrhagic events requiring transfusion were not different between the 2 groups. Unfortunately, liver-related morbidity and LT requirement were not described in this study.…”

Section: Discussionmentioning

confidence: 82%

Transcatheter aortic valve replacement (TAVR) as bridge therapy restoring eligibility for liver transplantation in cirrhotic patients

Lévy

Lassailly

Amrani

et al. 2020

American Journal of Transplantation

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Severe aortic stenosis is a widespread valve disease, constituting a contraindication to organ transplantation due to cardiovascular morbidity and projected mortality. Mortality after conventional surgical aortic valve replacement in cirrhotic patients depends upon the Child–Pugh class. In the past few years, transcatheter aortic valve replacement has progressively become the treatment of choice for high‐risk patients with severe aortic stenosis. Here, we report the cases of 3 cirrhotic patients who became eligible for liver transplantation after successful transcatheter aortic valve replacement as bridge therapy.

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Section: Discussionmentioning

confidence: 82%

Transcatheter aortic valve replacement (TAVR) as bridge therapy restoring eligibility for liver transplantation in cirrhotic patients

Lévy

Lassailly

Amrani

et al. 2020

American Journal of Transplantation

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“…Our results are consistent with previous studies that evaluated outcomes in cirrhotic patients, however, we are the first study to report these findings through a well‐validated algorithm for ESLD and confirm significant complications with SAVR as compared to TAVR. Findings from Reference reported no increase in risk of in‐hospital mortality for cirrhotic patients undergoing TAVR, however, it lacked a comparative analysis with SAVR. Reference analyzed NIS data from 2003 to 2014 and concluded that overtime there was a threefold increase in cirrhotic patients undergoing AVR.…”

Section: Discussionmentioning

confidence: 99%

“…4 Despite having a significant burden of patients with advanced liver disease and coexisting aortic valve stenosis, current risk prediction models such as Society of Thoracic Surgeons (STS) risk score (lack criteria to include this high-risk population. Previously reported studies have analyzed patients with cirrhosis; [5][6][7][8] however, there is paucity of data on utilization and clinical outcome of TAVR and surgical aortic valve replacement (SAVR) in population with end-stage liver disease (ESLD). 7 The objectives of our study are to evaluate contemporary trends in patients with ESLD undergoing TAVR or SAVR by incorporating a well-validated definition 9 of patients with ESLD in our analysis.…”

Section: Introductionmentioning

confidence: 99%

Contemporary trends and outcomes in aortic valve replacement in patients with end‐stage liver disease

Khan

Munir

Khan

et al. 2020

Cathet Cardio Intervent

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Objective: Even in high-risk trials pertaining to transcatheter aortic valve replacement (TAVR), patients with end-stage liver disease (ESLD) have been under-represented. We sought to study this population group from a large national United States population database. Methods: We used National Inpatient Sample (NIS) database from January 2005 to August 2015. Patients with ESLD were extracted using Goldberg's algorithm. Propensity match analysis was done for comparative analysis between surgical aortic valve replacement (SAVR) and TAVR groups. Logistic regression analysis was used for predictors of in-hospital mortality. Results: Out of 309,959 ESLD patients, 1,375 underwent aortic valve replacement and 1,199 patients were included in our study. Mean age was 66.1 (SD, 9.1) years. In matched data, the in-hospital mortality was 5.5% in TAVR group when compared to 19.4% in SAVR group. Ventilator use (16.1 vs. 27.2%, p < .01), tracheostomy (<4 vs. 7.2%, p < .01), and vasopressin use (0 vs. 7.4%, p < .01) were utilized less in TAVR group as compared to SAVR group. The proportion of TAVR has increased from almost zero in 2011 to 51.3% in 2015. Mean cost for hospital stay has increased in

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“…After a thorough digital search, 7 observational study containing 1652 patients ultimately satisfied our criteria and were included in this systematic review and meta-analysis. [14][15][16][17][18][19][20] No record of RCT was detected through the digital search. A sum of 1476 patients undergoing TAVI was recruited, among which 600 patients were afflicted with chronic liver disease.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Five studies were conducted in the USA and 3 of them utilized the data from NIS database and another 2 were single-center studies. [14,[16][17][18]20] One study was performed in Spain and 1 collecting the data from 12 institutions in Europe and Canada. [15,19] Five studies were cohort studies, among which 4 were propensity score-matched.…”

Section: Study Characteristicsmentioning

confidence: 99%

Transcatheter aortic valve implantation in the patients with chronic liver disease

Zhao

et al. 2020

Medicine

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Background: Chronic liver disease is traditionally conceived as a risk factor for cardiovascular surgery. Transcatheter aortic valve implantation (TAVI) has recently burgeoned to precede surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis at intermediate to high surgical risk. The evidence regarding TAVI in the patients with chronic liver disease is currently scarce.Methods: This article aims to assess the application of TAVI technique in the patients with chronic liver disease.Results: TAVI in the patients with chronic liver disease produced acceptable postoperative results. The post-TAVI outcomes were comparable between the patients with or without chronic liver disease, except for a lower rate of pacemaker implantation in the patients with chronic liver disease (OR, 0.49[0.27-0.87], P = .02). In the patients with chronic liver disease, compared to SAVR, TAVI led to a decrease in the in-hospital mortality (OR, 0.43[0.22-0.86], P = .02) and need for transfusion (OR, 0.39[0.25-0.62], P < .0001). The rest outcomes were similar between the 2 groups.Conclusions: This systematic review and meta-analysis supported that TAVI is a reliable therapeutic option for treating severe aortic stenosis in the patients with chronic liver disease. Future large-scale randomized controlled trials investigating the mid-term and long-term prognosis are needed to further verify these results.

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Outcomes and Effects of Hepatic Cirrhosis in Patients Who Underwent Transcatheter Aortic Valve Implantation

Cited by 10 publications

References 17 publications

Transcatheter aortic valve replacement (TAVR) as bridge therapy restoring eligibility for liver transplantation in cirrhotic patients

Transcatheter aortic valve replacement (TAVR) as bridge therapy restoring eligibility for liver transplantation in cirrhotic patients

Contemporary trends and outcomes in aortic valve replacement in patients with end‐stage liver disease

Transcatheter aortic valve implantation in the patients with chronic liver disease

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