Impact of Liver Cirrhosis on Early and Midterm Results After Transcatheter Aortic Valve Replacement: A Retrospective, Observational Study. Issue 3 (4th May 2019)

• Record Type: Journal Article
• Authors: Nakamura, Yuki; Kuratani, Toru; Torikai, Kei; Shimamura, Kazuo; Maeda, Koichi; Mizote, Isamu; Ichibori, Yasuhiro; Sakaniwa, Ryoto; Sakata, Yasushi; Sawa, Yoshiki
• Is Part Of: Structural heart. Volume 3:Issue 3(2019)
• Page Start: 236
• Page End: 243
• Publication Date: 2019-05-04
• Subjects: Transcatheter aortic valve replacement -- aortic valve stenosis -- liver cirrhosis -- cardiopulmonary bypass -- hypoalbuminemia; Heart -- Diseases -- Periodicals; Congenital heart disease -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular Diseases; Cardiovascular system -- Diseases; Congenital heart disease; Heart -- Diseases; Periodicals; 616.12
• DOI: 10.1080/24748706.2019.1595237
• Languages: English
• ISSNs: 2474-8706

Abstract

ABSTRACT: Background: Liver cirrhosis (LC) is a risk factor for open cardiac surgery; however, its impact on transcatheter aortic valve replacement (TAVR) remains unclear. This study aimed to validate the outcomes of TAVR for severe aortic valve stenosis (sAS) in patients with LC. Methods: Propensity score matching was performed using logistic regression, following which 22 patients with LC and 66 without LC, who underwent TAVR for sAS, were recruited. Early and midterm mortality and morbidity were compared between the LC and non-LC groups. Results: No significant difference was observed in perioperative results, including intraoperative bleeding and transfusion, 30-day mortality, and major morbidity, between the groups. Three-year-survival rate after TAVR was significantly lower (37.8%) in the LC group than in the non-LC group (85.9%) ( p < 0.001). Cox regression analysis revealed that serum albumin level was the sole independent risk factor for overall survival in patients with LC. Two-year survival rate in patients with LC having preoperative serum albumin level ≥3.0 g/dL was significantly lower than that in those having preoperative serum albumin level <3.0 g/dL (29.2% vs. 84.8%, p = 0.002). Conclusions: LC, belonging to Child–Pugh classes A and B, does not impact the early outcomes after TAVR. Preoperative hypoalbuminemia may affect the mid-term survival after TAVR in patients with LC.