Periprocedural transfusion in patients undergoing transfemoral transcatheter aortic valve implantation

Mayr, NP; Wiesner, G; Hapfelmeier, A; van der Starre, P; Husser, O; Bleiziffer, S; Schunkert, H; Lange, R; Tassani-Prell, P; Martin, K

doi:10.1002/ccd.27382

Institut für KI und Informatik in der Medizin (Prof. Rückert)

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Title:: Periprocedural transfusion in patients undergoing transfemoral transcatheter aortic valve implantation
Document type:: Article
Author(s):: Mayr, NP; Wiesner, G; Hapfelmeier, A; van der Starre, P; Husser, O; Bleiziffer, S; Schunkert, H; Lange, R; Tassani-Prell, P; Martin, K
Abstract:: Objectives: The aim of this investigation was to identify patients 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] - 0.141[0.079-0.251], 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.
Journal title abbreviation:: Catheter Cardiovasc Interv
Year:: 2018
Journal volume:: 92
Journal issue:: 1
Pages contribution:: 141-148
Language:: eng
Fulltext / DOI:: doi:10.1002/ccd.27382
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/29130582
Print-ISSN:: 1522-1946
TUM Institution:: Institut für Medizinische Statistik und Epidemiologie; Klinik für Herz- und Gefäßchirurgie (Prof. Lange)
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