RT Journal Article
T1 Clinical Outcomes and Prognosis Markers of Patients With Liver Disease Undergoing Transcatheter Aortic Valve Replacement: A Propensity Score-Matched Analysis.
A1 Tirado-Conte, Gabriela
A1 Rodés-Cabau, Josep
A1 Rodríguez-Olivares, Ramón
A1 Barbanti, Marco
A1 Lhermusier, Thibault
A1 Amat-Santos, Ignacio
A1 Toggweiler, Stefan
A1 Cheema, Asim N
A1 Muñoz-García, Antonio J
A1 Serra, Vicenc
A1 Giordana, Francesca
A1 Veiga, Gabriela
A1 Jiménez-Quevedo, Pilar
A1 Campelo-Parada, Francisco
A1 Loretz, Lucca
A1 Todaro, Denise
A1 Del Trigo, María
A1 Hernández-García, José M
A1 García Del Blanco, Bruno
A1 Bruno, Francesco
A1 de la Torre Hernández, José M
A1 Stella, Pieter
A1 Tamburino, Corrado
A1 Macaya, Carlos
A1 Nombela-Franco, Luis
K1 aortic valve
K1 liver diseases
K1 risk factor
K1 survival rate
K1 transcatheter aortic valve replacement
AB Chronic liver disease is a known risk factor for perioperative morbidity and mortality in patients undergoing cardiac surgery. Very little data exist about such patients treated with transcatheter aortic valve replacement (TAVR). Our objective was to evaluate early and late clinical outcomes in a large cohort of patients with liver disease undergoing TAVR and to determine predictive factors of mortality among these patients. This multicenter study collected data from 114 patients with chronic liver disease who underwent TAVR in 12 institutions. Perioperative and long-term outcomes were compared with a cohort of 1118 patients without liver disease after a propensity score-matching analysis (114 matched pairs). In-hospital mortality and vascular and bleeding complications were similar between matched groups. Acute kidney injury was more common in liver disease group (30.8% versus 13.5%; P=0.010). Although cardiovascular mortality was similar between groups (9.4% versus 6.5%; P=0.433) at 2-year follow-up, noncardiac mortality was higher in the liver group (26.4% versus 14.8%; P=0.034). Lower glomerular filtration rate (hazard ratio, 1.10, for each decrease of 5 mL/min in estimated glomerular filtration rate; 95% confidence interval, 1.03-1.17; P=0.005) and Child-Pugh class B or C (hazard ratio, 3.11; 95% confidence interval, 1.47-6.56; P=0.003) were the predictors of mortality in patients with chronic liver disease, with a mortality rate of 83.2% at 2-year follow-up in patients with both factors (estimated glomerular filtration rate  These findings suggested that TAVR is a feasible treatment for severe aortic stenosis in patients with early-stage liver disease or as bridge therapy before a curative treatment of the hepatic condition. Patients with Child-Pugh class B-C, especially in combination with renal impairment, had a very low survival rate, and TAVR should be carefully considered to avoid a futile treatment. These results may contribute to improve the clinical decision-making process and management in patients with liver disease.
YR 2018
FD 2018
LK http://hdl.handle.net/10668/12550
UL http://hdl.handle.net/10668/12550
LA en
DS RISalud
RD Apr 7, 2025