Biography: Zeyi Cheng
Objective: To investigate the effect of abnormal liver function on the outcome and safety after transcatheter
aortic valve implantation (TAVI) and whether TAVI is superior to surgical aortic valve replacement (SAVR) in
patients with hepatic insufficiency.
Methods: We searched the databases of PubMed, Embase, the Cochrane Library, Web of Science up to 31
January 2021. Studies to be eligible if mortality after TAVI in patients with and without hepatic insufficiency,
or mortality and complications for TAVI versus SAVR in patients with hepatic insufficiency were reported.
This meta-analysis was registered with PROSPERO (CRD42021247495) and was carried out by using RevMan
5.3 and Stata 14.0.
Results: This meta-analysis of 20 studies assessed a total of 220270 patients. Hepatic insufficiency was
associated with higher short-term mortality [OR=1.88, 95%CI (1.38 to 2.58), P<0.00001] and 1-2 years
mortality [OR=1.64, 95%CI (1.42 to 1.89), P<0.00001]. Between TAVI and SAVR in patients with hepatic
insufficiency, there is statistically significant difference in in-hospital mortality [OR=0.46, 95%CI (0.27 to
0.81), P=0.007], the occurrence rate of blood transfusions [OR=0.34, 95%CI (0.24 to 0.48), P<0.00001) and
the occurrence rate of acute kidney injury [OR=0.55, 95%CI (0.33 to 0.91), P=0.02].
Conclusions: TAVI patients with hepatic insufficiency may have negative impact both on short-term (inhospital
or 30-day) and 1-2-years mortality. For patients with hepatic insufficiency, TAVI could be a better
option than SAVR.
Keywords: transcatheter aortic valve implantation, surgical aortic valve replacement, hepatic insufficiency,