Author + information
- Matthew William Sherwooda,b,
- Katelyn Xianga,b,
- Roland Matsouakaa,b,
- Sreekanth Vemulapallia,b,
- Amit Voraa,b,
- Eric Petersona,b and
- Sunil Raoa,b
Background: Red blood cell (RBC) transfusion is common among cardiac surgery patients, yet there are few data available on RBC transfusion in patients undergoing transcatheter aortic valve replacement (TAVR).
Methods: Using the STS/ACC TVT Registry we evaluated patients undergoing TAVR from 1/1/11 to 3/31/16. The primary outcome was use of RBC transfusion. Secondary outcomes included in-hospital death and stroke. Outcomes were summated at the patient and site level. Multivariable logistic regression was used to determine the association of RBC transfusion with outcomes.
Results: Of the 57778 TAVR patients, 16537(28.6%) received at least one RBC transfusion. Rates of RBC transfusion varied across TAVR sites (med. 26.7%; IQR 18.5%, 35.9%). Site differences persisted after risk adjustment and exclusion of low volume sites (<25 TAVR) (Figure). Patients who received RBC transfusion were older, more often of female sex, and more likely to have HTN, PAD, CHF, severe COPD, and cardiogenic shock. Those receiving RBC transfusion had higher adjusted odds of in-hospital death (O.R. 8.47; 95% C.I. 4.89, 5.97) and stroke (2.45; 2.10, 2.86) compared with no RBC transfusion.
Conclusions: Over 25% of patients undergoing TAVR in the U.S. received a RBC transfusion, a rate that varied substantially among sites. Receipt of RBC transfusion was associated with higher risk of in-hospital death and stroke. Future investigation is needed to determine whether the frequency of RBC transfusions can be reduced in TAVR patients.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: TAVR 3
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1243-180
- 2017 American College of Cardiology Foundation