Risk of Bleeding after Transcatheter Aortic Valve Replacement: impact of Preoperative Antithrombotic Regimens

Introduction: Bleeding after transcatheter aortic valve replacement (TAVR) has a negative impact on the outcome of the procedure. Risk factors for bleeding vary widely in the literature, and the impact of preoperative antithrombotic agents has not been fully established. The objectives of our study...

Full description

Saved in:
Bibliographic Details
Published in:Revista brasileira de cirurgia cardiovascular 2022-01, Vol.37 (6), p.836-842
Main Authors: Albabtain, Monirah A., Arafat, Amr A., Alonaz, Zaid, Aluhaydan, Hanan, Alkharji, Mashael, Alsaleh, Raneem, Alboghdadly, Amany, AlOtaiby, Mohammed, AlAhmari, Saeed
Format: Article
Language:English
Subjects:
Anemia
Anticoagulants
CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiac arrhythmia
Clinical outcomes
Consortia
Fibrinolytic Agents
Heart attacks
Heart surgery
Hemoglobin
Hemorrhage
Ischemia
Meta-analysis
Mortality
Original
Patelet Aggregation Inhibitors
Renal Insufficiency
Risk factors
Stroke
SURGERY
Transcatheter Aortic Valve Replacement
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction: Bleeding after transcatheter aortic valve replacement (TAVR) has a negative impact on the outcome of the procedure. Risk factors for bleeding vary widely in the literature, and the impact of preoperative antithrombotic agents has not been fully established. The objectives of our study were to assess bleeding after TAVR as defined by the Valve Academic Research Consortium-2 (VARC-2), identify its risk factors, and correlate with antithrombotic treatment in addition to its effect on procedural mortality. Methods: The study included 374 patients who underwent TAVR from 2009 to 2018. We grouped the patients into four groups according to the VARC-2 definition of bleeding. Group 1 included patients without bleeding (n=265), group 2 with minor bleeding (n=22), group 3 with major bleeding (n=61), and group 4 with life-threatening bleeding (n=26). The median age was 78 (25th-75th percentiles: 71-82), and 226 (60.4%) were male. The median EuroSCORE was 3.4 (2-6.3), and there was no difference among groups (P=0.886). The TAVR approach was transfemoral (90.9%), transapical (5.6%), and trans-subclavian (1.9%). Results: Predictors of bleeding were stroke (OR: 2.465; P=0.024) and kidney failure (OR: 2.060; P=0.046). Preoperative single and dual antiplatelet therapy did not increase the risk of bleeding (P=0.163 and 0.1, respectively). Thirty-day mortality occurred in 14 patients (3.7%), and was significantly higher in patients with life-threatening bleeding (n=8 [30.8%]; P
ISSN:1678-9741
0102-7638
1678-9741
DOI:10.21470/1678-9741-2020-0538