{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:18:23Z","timestamp":1763457503557},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,5,11]],"date-time":"2015-05-11T00:00:00Z","timestamp":1431302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to high\u2010risk surgery in patients with comorbid conditions. The role of TAVR in patients with liver disease has not been examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined the procedural and intermediate to long\u2010term follow\u2010up outcomes of patients with severe symptomatic aortic valve stenosis and chronic liver disease, identified by liver biopsy or from a combination of clinical findings. All patients were treated with balloon\u2010expandable transfemoral (TF) or transapical (TA) TAVR between November 2007 and February 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 17 of 706 (2.41%) patients treated at our institution with TF [<jats:italic>n<\/jats:italic>\u2009=\u200914] or TA [<jats:italic>n<\/jats:italic>\u2009=\u20093] TAVR had chronic liver disease (mean age 77.65\u2009\u00b1\u20099.06 years, 7 women, mean STS score 8.37, mean Charlson score 5.00, mean MELD score 11.35, Child\u2013Turcotte\u2013Pugh (CTP) Class A [<jats:italic>n<\/jats:italic>\u2009=\u200911], B [<jats:italic>n<\/jats:italic>\u2009=\u20096], C [<jats:italic>n<\/jats:italic>\u2009=\u20090], biopsy proven liver disease [<jats:italic>n<\/jats:italic>\u2009=\u20095]). Median follow\u2010up was 466 days (range\u2009=\u200912\u20131,403 days). The mean post\u2010procedure length of hospital stay was 5.88\u2009\u00b1\u20093.08 days. Procedural success was achieved in all cases. In\u2010hospital mortality was 5.88% and 90\u2010day mortality was 17.65%. Safety and efficacy endpoints as defined by the valve academic research consortium (VARC) were significant for one perioperative death from a proximate cardiac cause (post\u2010operative day 14), one death after hospital discharge of unknown cause (post\u2010operative day 12), two late deaths from non\u2010cardiac causes (post\u2010operative days 50 and 487, respectively), and one late death of unknown cause (post\u2010operative day 1,005). There were no life\u2010threatening or major bleeding complications. One patient had an MI, one had a transient ischemic attack, four had transient, Stage I, acute kidney injury and one had transient, Stage II, acute kidney injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TF and TA TAVR are feasible methods for treating aortic stenosis in patients with chronic liver disease. In patients with mild to moderate chronic liver disease there are acceptable rates of early and late complications, however, outcomes in patients with advanced liver disease (MELD &gt;20 or CTP class C) warrant further study. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25994","type":"journal-article","created":{"date-parts":[[2015,5,11]],"date-time":"2015-05-11T11:13:28Z","timestamp":1431342808000},"page":"888-894","source":"Crossref","is-referenced-by-count":19,"title":["Outcomes of transcatheter aortic valve replacement in patients with chronic liver disease"],"prefix":"10.1002","volume":"86","author":[{"given":"Anoop M.","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Ogbara","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard C.","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Fox","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitul","family":"Kadakia","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saif","family":"Anwaruddin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph E.","family":"Bavaria","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nimesh D.","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Jagasia","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson Y.","family":"Szeto","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert H.","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashanth","family":"Vallabhajosyula","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Giri","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510290639"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2010.241190"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00296-4"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)90113-I"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(93)91143-B"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200208000-00004"},{"key":"e_1_2_6_8_1","unstructured":"STS Adult Cardiac Surgery Database Risk Model Variables\u2014Data Version 2.73. 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