Key result
Liver cirrhosis linked to ~56% lower 3-year survival after TAVR.
Why the study?
The impact of liver cirrhosis on outcomes after transcatheter aortic valve replacement for severe aortic valve stenosis remains unclear.
Does liver cirrhosis impact early and midterm mortality and morbidity in patients undergoing TAVR for severe aortic valve stenosis?
Observational (n=88)
Does liver cirrhosis impact early and midterm mortality and morbidity in patients undergoing TAVR for severe aortic valve stenosis?
Absolute Event Rate: 37.8% vs 85.9%
p-value: p=< 0.001
Liver cirrhosis does not impact early outcomes after TAVR, but is associated with significantly lower mid-term survival, particularly in patients with preoperative hypoalbuminemia.
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.
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Nakamura et al. (2019) conducted an observational in Severe aortic valve stenosis (n=88). Liver cirrhosis vs. No liver cirrhosis was evaluated on Three-year survival rate (p=< 0.001). Liver cirrhosis was associated with a significantly lower 3-year survival rate after TAVR compared to patients without cirrhosis (37.8% vs. 85.9%, p < 0.001).
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