Adverse impact of bleeding and transfusion on the outcome post-transcatheter aortic valve implantation: Insights from the Pooled-RotterdAm-Milano-Toulouse In Collaboration Plus (PRAGMATIC Plus) initiative

D Tchetche, Robert van der Boon, N Dumonteil, A Chieffo, Nicolas van Mieghem, B Farah, GL Buchanan, R Saady, B Marcheix, PWJC (Patrick) Serruys, A Colombo, D Carrie, Peter de Jaegere, J Fajadet

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Abstract

Background Little is known about the impact of bleeding and red blood cells transfusion (RBC) on the outcome post transcatheter aortic valve implantation (TAVI). Methods Between November 2005 and August 2011, 943 consecutive patients underwent TAVI. Bleeding was assessed according to the Valve Academic Research Consortium definitions. Patients receiving RBC were compared to those not requiring transfusion. Results Life-threatening and major bleedings occurred respectively in 13.9% and 20.9% of the patients, significantly more frequently in the RBC cohort. Vascular complications occurred in 23.2% of the patients. Major and minor vascular complications were more frequent in the RBC group: 19.3 vs 5.2%, P < .001; 15.3 vs 9%, P = .003, respectively. Thirty-day all-cause mortality was 7.2%. Of the overall cohort, 38.9% required RBC transfusion; those receiving at least 4 U of RBC had higher 30-day all- Conclusions Bleeding is frequent after TAVI, mainly driven by vascular complications. RBC transfusion was associated with increased mortality at 1 year and increased risk of major stroke and acute kidney injury. Specific scores are needed to identify the patients at higher risk for TAVI-related bleeding and RBC transfusion. (Am Heart J 2012;164:402-9.)
Original languageUndefined/Unknown
Pages (from-to)402-409
Number of pages8
JournalAmerican Heart Journal
Volume164
Issue number3
DOIs
Publication statusPublished - 2012

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