Safety and efficacy of protamine after transcatheter aortic valve replacement

Safety and efficacy of protamine after transcatheter aortic valve replacement

Transfemoral Trans-catheter Aortic Valve Replacement (TF-TAVR) is a safe alternative to surgical aortic valve replacement (SAVR). Protamine is used to reverse heparin and reduce post-TAVR bleeding, but concerns about risks like valve thrombosis and stroke remain. This systematic review and meta-anal...

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Main Authors: Lakshmi Durga Kumaraguruparan, Asuwin Anandaram, Kamalakkannan G. Sambandam, Yogapriya Chidambaram, Bharath Raj Kidambi, Gautam Ganesan Karthikeyan, Madhesh Kasi, Rizwan Suliankatchi Abdulkader, Sankaran Ramesh, Vadivelu Ramalingam, Ravindran Rajendran, Nagendra Boopathy Senguttuvan
Format: Article
Language:English
Published: Elsevier 2024-09-01
Series:Indian Heart Journal
Subjects:
Protamine
Transfemoral Trans-catheter aortic valve replacement
Vascular complications
Online Access:http://www.sciencedirect.com/science/article/pii/S0019483224001810
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Summary:Transfemoral Trans-catheter Aortic Valve Replacement (TF-TAVR) is a safe alternative to surgical aortic valve replacement (SAVR). Protamine is used to reverse heparin and reduce post-TAVR bleeding, but concerns about risks like valve thrombosis and stroke remain. This systematic review and meta-analysis, following PRISMA guidelines, found no statistically significant difference in major bleeding complications between the protamine and control groups [(3.0 % vs. 14.4 %); RR: 0.56; P = 0.16]. No differences were noted in life-threatening bleeding, blood transfusions, 30-day mortality, or stroke. Protamine appears safe post-TAVR without increasing stroke risk, but its effectiveness in reducing bleeding needs further investigation through a multicentric randomized study.
ISSN:0019-4832

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