Temporary Trends in Fever following Transcatheter Aortic Valve Implantation

Review of Bleeding and Thrombotic Risks Associated With Antithrombotic Therapy After Transcatheter Structural Heart Interventions

Transcatheter structural heart interventions have drastically evolved over the past 2 decades. However, most catheterization procedures require the deployment of devices in the body; therefore, the adhesion of thrombi to those devices is a major problem, resulting in the requirement of a period of postprocedural antithrombotic regimen. However, in recent years, bleeding associated with these antithrombotic therapies has also become a major concern, attracting the attention of investigators. This is complicated by the fact that patients at high thrombotic risk are also at high bleeding risk, making the issue of administrating antithrombotic therapy challenging. The objective of this review was to identify the important issues and summarize the current status of postoperative antithrombotic therapy and assessment of the bleeding risk following transcatheter structural heart interventions such as transcatheter aortic valve replacement, transcatheter edge-to-edge repair, and transcatheter left atrial appendage occlusion.

Analysis of risk factors for systemic inflammatory response syndrome in patients after transcatheter aortic valve replacement

OBJECTIVE

Our aim was to determine the risk factors of postoperative systemic inflammatory response syndrome (SIRS) in patients with transcatheter aortic valve replacement (TAVR), identify those with a high risk of SIRS, and help reduce SIRS occurrence.

METHODS

A retrospective cohort study was conducted to collect the clinical data of patients who underwent TAVR from January 2014 to December 2019 at a tertiary hospital in Zhejiang Province. The study included 156 men and 94 women. Patients were divided into SIRS and non-SIRS groups. The pre-, intra-, and postoperative indices of the two groups were recorded. The data of the two groups were compared, and univariate analysis was performed. All statistically significant factors were assessed using binary logistic regression analysis to clarify the risk factors of SIRS after TAVR.

RESULTS

Overall, 30 patients developed SIRS after TAVR, with an incidence rate of 12%, an odds ratio (OR) of 0.571, and a 95% confidence interval (CI) of 0.469-0.694 (p = 0.000). There was a significant correlation between SIRS and glucose (OR: 0.823, 95% CI: 0.678-1.000, p = 0.049), albumin (OR: 0.938, 95% CI: 0.881-0.998, p = 0.044), brain natriuretic peptide (OR: 1.000, 95% CI: 1.000-1.000, p = 0.010), sex (OR: 0.412, 95% CI: 0.190-0.892, p = 0.025), and history of hypertension (OR: 0.375, 95% CI: 0.169-0.819, p = 0.014). Multivariate regression analysis demonstrated that age (OR: 1.190, 95%CI: 1.073-1.319, p = 0.001) and body mass index (BMI; OR: 0.559, 95% CI: 0.447-0.698, p = 0.000) were independent risk factors for postoperative SIRS in patients with TAVR.

CONCLUSION

The incidence of SIRS after TAVR was 12%. There was a significant correlation between SIRS and albumin, glucose, and hypertension. The independent risk factors for SIRS after TAVR were age and BMI.