Risk of bleeding requiring blood transfusion after transcatheter implantation of the aortic valve in patients with concomitant coronary artery disease

• Published in: Aterotromboz (Online) Vol. 13; no. 1; pp. 74 - 84
• Main Authors: Nurkhametova, A. A., Imaev, T. E., Komlev, A. E., Kurbanov, S. K., Ageev, F. T., Lepilin, P. M., Kolegaev, A. S., Akchurin, R. S.
• Format: Journal Article
• Language: English; Russian
• Published: REMEDIUM GROUP» Ltd 03.08.2023
• Subjects: dual antiplatelet therapy; perioperative bleeding; risk factors of bleeding; transcatheter aortic valve replacement
• ISSN: 2307-1109; 2658-5952
• DOI: 10.21518/at2023-005

Introduction . Perioperative bleeding is a potentially life-threatening complication of surgical intervention. The incidence of perioperative bleeding during transcatheter aortic valve implantation (TAVI) reaches 6%. An increased risk of perioperative bleeding is noted in patients requiring constant antiplatelet therapy, which includes patients with concomitant coronary artery disease (CAD). Aim . The study of risk factors of bleeding, which require blood transfusion in candidates for TAVI with concomitant CAD. Materials and methods . A retrospective study. The patients with concomitant CAD who underwent TAVI from 2016 to 2021 with hemodynamically significant coronary artery stenosis (n = 270) were included in this study. The incidence of early postoperative bleeding requiring blood transfusions was analyzed. Risk factors of bleeding development were evaluated. Results . The average age of the patients was 77.7 ± 7.2 years, the number of male and female patients was comparable (45.9 and 54.1%).The majority of patients were diagnosed with chronic heart failure (90.4%), more than half of the patients suffered from pulmonary hypertension (51.9%). The incidence of bleeding that required blood transfusion was 9.3%. The risk factors of the bleeding were dual antiplatelet therapy, baseline anemia (hemoglobin less than 120 g/l), history of stroke, chronic renal failure and critical aortic stenosis. The risk factors were included in the predictive model. Conclusion . Bleeding requiring blood transfusion in patients with severe aortic stenosis and CAD after TAVR occurs in 9.3%. It can be partially predicted using the predictive model. The using of the predictive model may be useful in determining the predominant risk of thrombotic or bleeding events after surgery.