Outcomes of Transcatheter Aortic Valve Implantation in Patients with Cirrhosis.

Outcomes of Transcatheter Aortic Valve Implantation in Patients with Cirrhosis. Int Heart J. 2019 Feb 08;: Authors: Higuchi R, Tobaru T, Hagiya K, Saji M, Mahara K, Takamisawa I, Shimizu J, Iguchi N, Takanashi S, Takayama M, Isobe M Abstract Cirrhosis is a significant adverse factor of cardiac surgeries. Transcatheter aortic valve implantation (TAVI) has evolved as a less invasive therapy for aortic stenosis, whereas detailed case analysis of TAVI in cirrhotic patients is limited.Among 444 consecutive patients who underwent TAVI in the Sakakibara Heart Institute between October 2013 and January 2018, we retrospectively reviewed 11 patients (2.5%) with cirrhosis. All outcomes were defined according to the Valve Academic Research Consortium-2 criteria.The median age of the patients was 82 years, and eight (73%) were female. Seven patients (64%) were Child-Turcotte-Pugh class A, and four patients (36%) were class B. The Model for End-Stage Liver Disease score was 10 (7.0-13). TAVI was performed using Edwards SAPIEN XT/SAPIEN3 in nine patients (82%), and Medtronic CoreValve/Evolut R in two patients (18%), via transfemoral (n = 8, 73%) or transapical (n = 3, 27%) approach. The device success rate was 100% and no extracorporeal circulation had been inducted. No death, stroke, life-threatening bleeding, and acute kidney injury stage 2 or 3 occurred within 30 days, but three major bleeding events (27%) were documented (two access-site bleedi...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research