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

Author:

Doshi Rajkumar1,Adalja Devina2,Zala Harshvardhan3,Victor Varun4,Sheth Aakash5,Willyard Charles6,Suzuki Emi7,Patel Harsh P.8,Majmundar Monil9,Vallabhajosyula Saraschandra10

Affiliation:

1. Department of Cardiology, St Joseph\'s University Medical Center, Paterson, NJ, USA

2. Department of Internal Medicine, St Joseph\'s University Medical Center, Paterson, NJ, USA

3. Department of Clinical Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA

4. Department of Internal Medicine, Canton Medical Education Foundation, Canton, OH, USA

5. Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA

6. Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA

7. Department of Pediatrics, UCSF- Fresno, Fresno, CA, USA

8. Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA

9. Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA

10. Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston- Salem, NC, USA

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.

Publisher

Bentham Science Publishers Ltd.

Subject

Cardiology and Cardiovascular Medicine,General Medicine

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