Safety and efficacy of protamine after transcatheter aortic valve replacement

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Indian heart journal Pub Date : 2024-09-01 DOI:10.1016/j.ihj.2024.09.001

Lakshmi Durga Kumaraguruparan , Asuwin Anandaram , Kamalakkannan G. Sambandam , Yogapriya Chidambaram , Bharath Raj Kidambi , Gautam Ganesan Karthikeyan , Madhesh Kasi , Rizwan Suliankatchi Abdulkader , Sankaran Ramesh , Vadivelu Ramalingam , Ravindran Rajendran , Nagendra Boopathy Senguttuvan

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Abstract

Transfemoral Trans-catheter Aortic Valve Replacement (TF-TAVR) is a safe alternative to surgical aortic valve replacement (SAVR). Protamine is used to reverse heparin and reduce post-TAVR bleeding, but concerns about risks like valve thrombosis and stroke remain. This systematic review and meta-analysis, following PRISMA guidelines, found no statistically significant difference in major bleeding complications between the protamine and control groups [(3.0 % vs. 14.4 %); RR: 0.56; P = 0.16]. No differences were noted in life-threatening bleeding, blood transfusions, 30-day mortality, or stroke. Protamine appears safe post-TAVR without increasing stroke risk, but its effectiveness in reducing bleeding needs further investigation through a multicentric randomized study.

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经导管主动脉瓣置换术后使用质胺的安全性和有效性。

经口经导管主动脉瓣置换术（TF-TAVR）是外科主动脉瓣置换术（SAVR）的安全替代方案。原胺用于逆转肝素并减少TAVR术后出血，但对瓣膜血栓和中风等风险的担忧依然存在。这项系统回顾和荟萃分析遵循了 PRISMA 指南，发现在大出血并发症方面，丙胺组和对照组之间没有统计学意义上的显著差异[（3.0 % vs. 14.4 %）；RR：0.56；P = 0.16]。在危及生命的出血、输血、30 天死亡率或中风方面没有差异。TAVR术后使用普罗胺似乎是安全的，不会增加中风风险，但其减少出血的效果还需要通过多中心随机研究进行进一步调查。

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来源期刊

Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

52 days

期刊介绍： Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.