TAVR safe and effective for patients with cirrhosis
Transcatheter aortic valve replacement (TAVR) is a “relatively safe and robust treatment option” for patients with severe aortic stenosis (AS) and cirrhosis of the liver, according to new findings published in the American Journal of Cardiology.
The study’s authors tracked 32 adult patients who underwent TAVR from April 2015 to December 2018 at the same high-volume facility. Data were compared with nearly 1,000 additional adult patients treated during the same time period who did not have cirrhosis.
Patients with cirrhosis had a lower mean age (74.5 years old) than patients that did not have cirrhosis (81.2 years old). They also had a lower 30-day mortality rate, but similar one-year and two-year mortality rates.
Patients with cirrhosis were less likely to require a permanent pacemaker after the procedure, but more likely to be hospitalized for heart failure within 30 days. Bleeding and vascular outcomes, meanwhile, were similar between the two groups.
“Patients with cirrhosis of the liver have traditionally been considered to represent a higher-risk substrate when undergoing cardiac surgery,” wrote Hassan Mehmood Lak, MD, department of internal medicine at Cleveland Clinic, and colleagues.
Their findings, however, found that the risks these patients face are similar to any other patient group, “again validating the safety of TAVR in patients with liver disease.”
“Patients with liver cirrhosis undergo TAVR at a younger age than patients without cirrhosis but have comparable outcomes at 30 days and 1 year after TAVR,” the authors concluded. “TAVR provides a relatively safe and robust treatment option for patients with liver cirrhosis and severe symptomatic AS.”
Read the full analysis here.