Incidence, Current Guidelines and Management of Gastrointestinal Bleeding after Transcatheter Aortic Valve Replacement: A Systematic Review.

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Current Cardiology Reviews Pub Date : 2023-01-01 DOI:10.2174/1573403X18666220623150830

Devina Adalja, Harshvardhan Zala, Varun Victor, Aakash Sheth, Charles Willyard, Emi Suzuki, Harsh P Patel, Monil Majmundar, Saraschandra Vallabhajosyula, Rajkumar Doshi

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Abstract

Background: There is a significant increase in morbidity and mortality in patients complicated by major bleeding following transcatheter aortic valve replacement (TAVR). It has become more challenging to manage such complications when the patient needs to be on anticoagulation or antiplatelet agent post-procedure to prevent thrombotic/embolic complications.

Methods: We systematically reviewed all available randomized controlled trials and observational studies to identify incidence rates of gastrointestinal bleeding post-procedure. After performing a systematic search, a total of 8731 patients from 15 studies (5 RCTs and 10 non-RCTs) were included in this review.

Results: The average rate of gastrointestinal bleeding during follow-up was 3.0% in randomized controlled trials and 1.9% among observational studies.

Conclusion: Gastrointestinal bleeding has been noted to be higher in the RCTs as compared to observational studies. This review expands knowledge of current guidelines and possible management of patients undergoing TAVR.

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经导管主动脉瓣置换术后胃肠道出血的发生率、当前指南和管理：一项系统综述。

背景：经导管主动脉瓣置换术（TAVR）后并发大出血的患者的发病率和死亡率显著增加。当患者在术后需要服用抗凝剂或抗血小板药物以预防血栓/栓塞并发症时，处理此类并发症变得更具挑战性。方法：我们系统地回顾了所有可用的随机对照试验和观察性研究，以确定术后胃肠道出血的发生率。在进行系统搜索后，来自15项研究（5项随机对照试验和10项非随机对照试验）的8731名患者被纳入本综述。结果：在随机对照试验中，随访期间胃肠道出血的平均发生率为3.0%，在观察性研究中为1.9%。结论：与观察性研究相比，随机对照试验中的胃肠道出血率更高。这篇综述扩展了对接受TAVR的患者的当前指南和可能的管理的了解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

10.50%

发文量

117

期刊介绍： Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.