Clinical Outcomes of Transcatheter vs Surgical Aortic Valve Replacement in Patients With Chronic Liver Disease: A Systematic Review and Metaanalysis

摘要: Background: Chronic liver disease increases cardiac surgical risk, with 30-day mortality ranging from 9% to 52% in patients Child-Pugh class A and C, respectively. Data comparing the outcomes of transcatheter aortic valve replacement (TAVR) (SAVR) are limited. Methods: We searched PubMed, Cochrane Library, Web Science, Google Scholar for relevant studies assessed risk bias using Risk Bias Non-Randomized Studies – Interventions (ROBINS-I) Collaboration tool. Results: Five observational 359 TAVR 1,872 SAVR were included analysis. Overall, undergoing had a statistically insignificant lower rate in-hospital (7.2% vs 18.1%; odds ratio [OR] 0.67; 95% confidence interval [CI] 0.25, 1.82; I2=61%) than receiving SAVR. In propensity score–matched cohorts, rates (7.3% 13.2%; OR 0.51; CI 0.27, 0.98; I2=13%), blood transfusion (27.4% 51.1%; 0.36; 0.21, 0.60; I2=31%), hospital length stay (10.9 15.7 days; mean difference –6.32; –10.28, –2.36; I2=83%) having No significant differences between 2 interventions detected proportion discharged home (65.3% 53.9%; 1.3; 0.56, 3.05; I2=67%), acute kidney injury (10.4% 17.1%; 0.55; 0.29, 1.07; I2= 0%), or cost hospitalization ($250,386 $257,464; standardized –0.07; –0.29, 0.14; I2=0%). Conclusion: chronic disease, may be associated mortality, transfusion, compared