Outcomes After Transfemoral Transcatheter Aortic Valve Implantation With a SAPIEN 3 Valve in Patients With Cirrhosis of the Liver (a Tertiary Care Center Experience)

Am J Cardiol. 2021 Dec 1:160:75-82. doi: 10.1016/j.amjcard.2021.08.043. Epub 2021 Sep 26.

Abstract

Little is known about the utility of transcatheter aortic valve implantation (TAVI) in patients with cirrhosis of the liver, and their outcomes have not been studied extensively in literature. We performed a retrospective analysis of patients with severe symptomatic aortic stenosis (AS) who underwent transfemoral TAVI with a SAPIEN 3 valve at our institution between April 2015 and December 2018. We identified 32 consecutive patients with evidence of cirrhosis of the liver on imaging (including ultrasound and/or computed tomography) and patients with severe symptomatic AS who underwent transfemoral TAVI with a SAPIEN 3 valve. Among 1,028 patients, 32 had cirrhosis of the liver and 996 constituted the control group without cirrhosis. Mean age in the cirrhosis group was 74.5 years compared with 81.2 years in the control group. Baseline variables were comparable between the groups. Compared with the noncirrhotic group, patients with cirrhosis had a similar 1-year mortality (12% vs 12%, p = 1), a lower 30-day new pacemaker after TAVI rate (6% vs 9%, p = 0.85), a higher 30-day and 1-year readmission rate for heart failure (11% vs 1% and 12% vs 5%, p = 0.12, respectively), and a similar 1-year major adverse cardiac and cerebrovascular event rate (15% vs 14%, p = 0.98). In conclusion, patients with severe AS with concomitant liver cirrhosis who underwent TAVI demonstrated comparable outcomes to their noncirrhotic counterparts.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / surgery*
  • Cardiac Pacing, Artificial
  • Case-Control Studies
  • Female
  • Femoral Artery*
  • Heart Block / epidemiology*
  • Heart Block / therapy
  • Heart Failure / epidemiology
  • Hepatorenal Syndrome / epidemiology
  • Humans
  • Liver Cirrhosis / complications*
  • Male
  • Mortality
  • Myocardial Infarction / epidemiology
  • Pacemaker, Artificial
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Severity of Illness Index
  • Tertiary Care Centers
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome