Outcomes of transcatheter vs surgical aortic valve replacement in pre-existing chronic liver disease patients: A meta-analysis of observational studies

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-03-28 DOI:10.1016/j.ijcha.2025.101651

Aizaz Ali , Muhammad Abdullah Ali , Asad Iqbal Khattak , Fazia Khattak , Abdullah Afridi , Touba Azeem , Umme Salma Shabbar Banatwala , Umama Alam , Ayesha Khan , Urbe Jalal , Abdul Moeez , Malik W.Z. Khan , Peter Collins , Raheel Ahmed

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Abstract

Aortic valve stenosis in patients with chronic liver diseases, particularly liver cirrhosis and End-Stage Liver Disease, poses significant management challenges due to the interplay between cardiovascular and hepatic dysfunction. This systematic review and meta-analysis compared the safety and efficacy of Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement in this high-risk population. An extensive search of PubMed, Embase, and Web of Science (inception to January 5, 2025) identified 11 retrospective studies comprising 19,097 patients. Risk ratios for dichotomous outcomes and mean differences (MD) for continuous outcomes, each with 95% confidence intervals, were calculated using random-effects models.

The analysis revealed that TAVR significantly reduced hospital mortality (RR 0.36, 95 % CI: 0.30–0.42; I² = 7.6 %), acute kidney injury (RR 0.51, 95 % CI: 0.33–0.78; I² = 57.2 %), bleeding (RR 0.33, 95 % CI: 0.28–0.39; I² = 0.0 %), stroke (RR 0.35, 95 % CI: 0.23–0.51; I² = 6.1 %), and blood transfusion (RR 0.48, 95 % CI: 0.40–0.57; I² = 7.6 %). TAVR was also associated with shorter hospital stays (MD −6.77 days, 95 % CI: −9.17 to −4.38; I² = 97.5 %). No significant differences were observed in vascular complications requiring surgery or hospital charges and post-operative infections.

These findings suggest TAVR offers significant advantages over SAVR in reducing complications such as mortality, acute kidney injury, and bleeding in patients with liver disease. However, further randomized trials are necessary to confirm long-term outcomes and establish optimal treatment strategies for this high-risk population.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.