• Xiaochun Ma, Diming Zhao, Jinzhang Li, Dong Wei, Jianlin Zhang, Peidong Yuan, Xiangqian Kong, Jiwei Ma, Huibo Ma, Liangong Sun, Yuman Zhang, Qiqi Jiao, Zhengjun Wang, and Haizhou Zhang.
• Department of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong University, and Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong 250021.
• Medicine (Baltimore). 2020 Apr 1; 99 (16): e19766.

BackgroundChronic liver disease is traditionally conceived as a risk factor for cardiovascular surgery. Transcatheter aortic valve implantation (TAVI) has recently burgeoned to precede surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis at intermediate to high surgical risk. The evidence regarding TAVI in the patients with chronic liver disease is currently scarce.MethodsThis article aims to assess the application of TAVI technique in the patients with chronic liver disease.ResultsTAVI in the patients with chronic liver disease produced acceptable postoperative results. The post-TAVI outcomes were comparable between the patients with or without chronic liver disease, except for a lower rate of pacemaker implantation in the patients with chronic liver disease (OR, 0.49[0.27-0.87], P = .02). In the patients with chronic liver disease, compared to SAVR, TAVI led to a decrease in the in-hospital mortality (OR, 0.43[0.22-0.86], P = .02) and need for transfusion (OR, 0.39[0.25-0.62], P < .0001). The rest outcomes were similar between the 2 groups.ConclusionsThis systematic review and meta-analysis supported that TAVI is a reliable therapeutic option for treating severe aortic stenosis in the patients with chronic liver disease. Future large-scale randomized controlled trials investigating the mid-term and long-term prognosis are needed to further verify these results.

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