Abstract 14026: The Impact of Hemoglobin Drop, Bleeding Events and Blood Transfusion on Long Term Mortality Following Transcatheter Aortic Valve Implantation
Background: Despite the minimally invasive nature of trans-catheter aortic valve implantation (TAVI), the procedure is associated with several complications. We analyzed the individual impact of bleeding events, hemoglobin (Hb) drop, and Red Blood Cells (RBC) transfusions on prognosis.
Methods and results: Consecutive patients (n=597) undergoing trans-femoral TAVI were prospectively enrolled. Peri-procedural Hb levels, RBC transfusions and major/life threatening bleeding events were documented and analyzed. To study the relationship between Hb drop, RBC transfusions and long-term mortality, the entire cohort was divided into 4 groups according to Hb drop (less or ≥ than 3 g/dl), and receiving RBC transfusion (yes /no). In the entire cohort mean Hb level decreased following TAVI (11.8±1.4 to 9.5 ±1.3 g/dl; p<0.001). Major/ life threatening bleedings occurred in 66 (10.1%) patients, and 179 (30%) patients received RBC transfusions. Major/life threatening bleedings were not independently associated with mortality when adjusted to Hg drop and RBC transfusion. Among patients with Hb drop of < 3 g/dl, those who received blood transfusion had higher mortality (HR 1.9 CI 1.2-2.9; p=0.004). Among patients with Hb drop of ≥ 3 g/dl, the Hb drop had no significant impact on survival (HR 1.5 CI 0.7-2.9; p=0.2), however, patients that received blood transfusions had a significantly higher mortality (HR 4.1 CI 2.2-7.7; p<0.001).
Conclusion: Hb drop is frequently observed following TAVI. RBC transfusion is strongly associated with increased long-term mortality in these patients, regardless of the degree of Hb drop.
Author Disclosures: M. Konigstein: None. O. Havakuk: None. A. Finkelstein: None. J. Ben shoshan: None. G. Keren: None. S. Banai: None.
- © 2015 by American Heart Association, Inc.