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Meta-Analysis
. 2024 Sep-Oct;76(5):352-354.
doi: 10.1016/j.ihj.2024.09.001. Epub 2024 Sep 24.

Safety and efficacy of protamine after transcatheter aortic valve replacement

Lakshmi Durga Kumaraguruparan  1 , Asuwin Anandaram  2 , Kamalakkannan G Sambandam  3 , Yogapriya Chidambaram  4 , Bharath Raj Kidambi  5 , Gautam Ganesan Karthikeyan  6 , Madhesh Kasi  7 , Rizwan Suliankatchi Abdulkader  8 , Sankaran Ramesh  9 , Vadivelu Ramalingam  10 , Ravindran Rajendran  11 , Nagendra Boopathy Senguttuvan  12
Affiliations
Meta-Analysis

Safety and efficacy of protamine after transcatheter aortic valve replacement

Lakshmi Durga Kumaraguruparan et al. Indian Heart J. 2024 Sep-Oct.

Abstract

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.

Keywords: Protamine; Transfemoral Trans-catheter aortic valve replacement; Vascular complications.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dr. Nagendra Boopathy Senguttuvan reports administrative support, statistical analysis, and writing assistance were provided by Sri Ramachandra Institute of Higher Education and Research (Deemed to be University). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Outcomes with and without protamine post-TAVR.
See this image and copyright information in PMC

References

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