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

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

doi:10.2174/1573403X18666220623150830

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

Curr Cardiol Rev. 2023;19(1):e230622206351. doi: 10.2174/1573403X18666220623150830.

Authors

Affiliations

¹ Department of Internal Medicine, St Joseph\'s University Medical Center, Paterson, NJ, USA.
² Department of Clinical Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
³ Department of Internal Medicine, Canton Medical Education Foundation, Canton, OH, USA.
⁴ Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
⁵ Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA.
⁶ Department of Pediatrics, UCSF- Fresno, Fresno, CA, USA.
⁷ Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA.
⁸ Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA.
⁹ Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston- Salem, NC, USA.
¹⁰ Department of Cardiology, St Joseph\'s University Medical Center, Paterson, NJ, 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.

Keywords: TAVR; Transcatheter aortic valve implantation; anticoagulation; antiplatelet; gastrointestinal bleeding; review.

Publication types

Systematic Review

MeSH terms

Aortic Valve / surgery
Aortic Valve Stenosis* / surgery
Gastrointestinal Hemorrhage / epidemiology
Gastrointestinal Hemorrhage / etiology
Gastrointestinal Hemorrhage / therapy
Humans
Incidence
Risk Factors
Transcatheter Aortic Valve Replacement* / adverse effects
Transcatheter Aortic Valve Replacement* / methods
Treatment Outcome