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Acta Cardiol. 2018 Feb;73(1):50-59. doi: 10.1080/00015385.2017.1327627. Epub 2017 Aug 16.

Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia.

Author information

1
a Centre for Global Health, Istituto Superiore di Sanità , Rome , Italy.
2
b Oulu University Hospital , Oulu , Finland.
3
c Ferrarotto Hospital, University of Catania , Catania , Italy.
4
d IRCCS Policlinico San Donato , San Donato Milanese , Milan , Italy.
5
e Careggi Hospital , Florence , Italy.
6
f Department of Epidemiology , Lazio Regional Health Service , Rome , Italy.

Abstract

OBJECTIVES:

We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis.

METHODS:

Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis.

RESULTS:

Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1.37, 95% CI 1.12-1.68) and SAVR (HR 1.63, 95% CI 1.37-1.99). Propensity score matching resulted in 302 pairs with similar characteristics. Patients undergoing SAVR had similar 30-d mortality (3.6% versus 3.3%, p = .81) and stroke (1.3% versus 2.0%, p = .53) compared with TAVI. The rates of pacemaker implantation (18.6% versus 3.0%, p < .001), major vascular damage (5.7% versus 0.4%, p < .001) and mild-to-severe paravalvular regurgitation (47.4% versus 9.3%, p < .001) were higher after TAVI, whereas acute kidney injury (50.7% versus 27.9%, p < .001) and blood transfusion (70.0% versus 38.6%, p < .001) were more frequent after SAVR. At 3-year, survival was 74.0% after SAVR and 66.3% after TAVI, respectively (p = .065), and freedom from MACCE was 67.6% after SAVR and 58.7% after TAVI, respectively (p = .049).

CONCLUSIONS:

These results suggest that TAVI is not superior to SAVR in patients with anaemia.

KEYWORDS:

Anaemia; TAVI; TAVR; anaemic; aortic valve replacement; aortic valve stenosis

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