Transfemoral transcatheter aortic valve implantation required periprocedural transfusion in 14% of patients, with female gender (OR 1.68) and moderate anemia (OR 7.59) as significant predictors.
Cohort (n=1,734)
What patient characteristics and periprocedural variables are associated with periprocedural red blood cell transfusion in patients undergoing transfemoral TAVI?
In patients undergoing transfemoral TAVI, procedural experience, serious adverse events, low hemoglobin levels, and female gender are the main predictors of periprocedural red blood cell transfusion.
OBJECTIVES: The aim of this investigation was to identify patient's characteristics and periprocedural variables related to periprocedural transfusion in transfemoral Transcatheter Aortic Valve Implantation (tf-TAVI). BACKGROUND: Transfusion of allogenic red-blood cells (RBC) in tf-TAVI and the number of transfused units has been linked to an increased 30-day mortality. In line with the trend of minimization and cost-effectiveness, transfusion should be avoided, wherever possible. METHODS: Between 2007 and 2015, 1,734 procedures were analyzed from our prospective registry for RBC-transfusion. Multiple logistic regression analysis was used to identify the dependent variables. RESULTS: Transfusion was considered necessary in 14% (n = 243) of the patients. Female gender (OR 95% CI) (1.680 1.014-2.783) and preprocedural moderate (7.594 4.404-13.095) and severe anemia (8.202 0.900-74.752) according to WHO were the most important preprocedural variables. Periprocedural, pericardial effusion (12.109 3.753-39.063), emergency extracorporeal circulation (54.5288 6.178-481.259) and major vascular injury (2.647 1.412-4.962) were related to transfusion. The same applies to moderate (4.255 1.859-9.740) and severe anemia (31.567 8.560-116.416) as well as periprocedural experience (0.072 0.035-0.149 - 0.1410.079-0.251, P < 0.001) CONCLUSION: Procedural experience, serious adverse events, low pre- and periprocedural Hb levels and female gender were the main variables relating to transfusion. Even in experienced high-volume centers, transfusion is still necessary in a considerable number of patients.
Mayr et al. (Sat,) conducted a cohort in Transfemoral transcatheter aortic valve implantation (n=1,734). Risk factors for periprocedural transfusion was evaluated on Periprocedural transfusion. Transfemoral transcatheter aortic valve implantation required periprocedural transfusion in 14% of patients, with female gender (OR 1.68) and moderate anemia (OR 7.59) as significant predictors.
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