Indian Heart Journal (Sep 2024)

Safety and efficacy of protamine after transcatheter aortic valve replacement

  • 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

Journal volume & issue
Vol. 76, no. 5
pp. 352 – 354

Abstract

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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.

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