RBC transfusion after TAVR increases death risk: Circulation

Italy: RBC transfusion after TAVR is associated with increased mortality and acute kidney injury (AKI), according to a recent study in the journal Circulation: Cardiovascular Interventions. The transfusion is associated with 30-day mortality, independent of periprocedural major bleeding and vascular complications.

Periprocedural bleeding in patients undergoing transcatheter aortic valve replacement (TAVR) have reduced owing to improvements in technology and technique. Still, it remains common and red blood cell (RBC) transfusion are administered frequently. Previous studies have shown associations between transfusion and worse outcomes including mortality and AKI. 

However, it is unclear whether transfusion is a marker of poor outcomes or a casual driver of these events. But there is no consensus on the benefit of RBC transfusion after TAVR , the issue is not directly addressed in clinical guidelines. 

The multicenter Transfusion Requirements in Transcatheter Aortic Valve Implantation (TRITAVI) registry by Marco Zimarino, Institute of Cardiology, "G. d'Annunzio" University Chieti-Pescara, Italy, and colleagues retrospectively included patients after transfemoral TAVR; propensity score-matching identified pairs of patients with and without RBC transfusion.