title: Association Between Blood Transfusions and 12-Month Mortality After Transcatheter Aortic Valve Implantation.
abstract: Blood transfusions are considered as an important predictor of adverse outcome in patients with severe aortic (AS) undergoing transcatheter aortic valve implantation (TAVI). We sought to investigate the association between blood transfusions and mortality after TAVI. We enrolled 101 consecutive patients with severe AS undergoing TAVI. Patients who required transfusion were defined as patients in whom at least one unit of packed red blood cells (PRBCs) was transfused in the perioperative period. Twelve-month outcomes were assessed based on Valve Academic Research Consortium definitions. A total of 28 (27.7%) patients required blood transfusion after TAVI. Baseline characteristics of the patients with and without a transfusion were similar. Median amount of PRBCs was 2 (interquartile range, 2-4). Twelvemonth all-cause mortality was higher in patients with than without a blood transfusion (39.3% versus 9.6%; P = 0.001). Importantly, the need for a blood transfusion after TAVI was an independent predictor of higher mortality rates after 12 months (hazard ratio (HR) 2.84 95%CI (1.06-7.63); P = 0.039; (HR for incomplete coronary revascularization 10.86, 95%CI 3.72-31.73; P < 0.001; HR for a history of stroke/TIA 3.93, 95%CI 1.39-11.07; P < 0.001). The duration of inhospital stay was longer in patients requiring transfusion (16.0 (14.0-22.0) versus 7.0 (7.0-11.5) days; P = 0.014). In conclusion, blood transfusions after TAVI were associated with higher mortality rates after 12 months, longer in-hospital stay, and were identified as an independent predictor of impaired clinical outcome.
authors.affiliation: Institute of Cardiology, University Hospital.
authors.forename: Pawel
authors.initials: P
authors.lastname: Kleczynski
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Maciej
authors.initials: M
authors.lastname: Bagienski
authors.forename: Lukasz
authors.initials: L
authors.lastname: Rzeszutko
authors.forename: Danuta
authors.initials: D
authors.lastname: Sorysz
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Trebacz
authors.forename: Robert
authors.initials: R
authors.lastname: Sobczynski
authors.forename: Marek
authors.initials: M
authors.lastname: Tomala
authors.forename: Maciej
authors.initials: M
authors.lastname: Stapor
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality*