We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App




TAVR Bleeding Complications Can Predict Mortality

By HospiMedica International staff writers
Posted on 07 Aug 2017
Print article
Patients with severe aortic stenosis who experience bleeding complications following transcatheter aortic valve replacement (TAVR) face an increased risk for mortality, according to a new study.

Researchers at Swiss Cardiovascular Center Bern (CVRC; Switzerland) and the University of Bern (Switzerland) conducted a study involving 926 consecutive patients who underwent TAVR from 2007 through 2014 in order to examine frequency, timing, and association of access-site and non–access-site bleeding with mortality. Bleeding was assessed according to Valve Academic Research Consortium 2 (VARC2) criteria. The primary outcome of interest was all-cause mortality up to five years of follow-up.

The results revealed that 30.7% of patients had at least one subsequent bleeding event, which were split between bleeds from the access site and those at other sites. In all, 80% of the bleeding events occurred within the first 30 days after TAVR. In fact, all access-site bleeds took place during this early period; 40% of non-access-site bleeds happened later on throughout the follow-up period. For those who underwent transfemoral access, access-site bleeding did not significantly increase the risk of mortality, but non-access-site bleeding did.

Most access-site bleeds were minor, while non-access-site bleeds tended to be major. Minor bleeding was not significantly associated with mortality over follow-up, unlike major bleeds and life-threatening ones. Death from any cause was less likely for patients with access-site bleeds (58.7%) than non-access-site bleeds (72.8%). Analysis revealed that female sex was a significant correlate of access-site bleeding, whereas chronic kidney disease (CKD) was significantly associated with non–access-site bleeding. The study was published on July 24, 2017, in JACC: Cardiovascular Interventions.

“These findings parallel those observed in the field of percutaneous coronary intervention [PCI], in which non–access-related major bleeding complications have a significantly greater impact on mortality compared with access-site complications,” concluded senior author Stefan Stortecky, MD, of CVRC, and colleagues. “Non–access-site bleeding is a multifactorial event that encapsulates the patient risk profile as well as coexisting comorbidities, and whose risk is longitudinal and extends over time, which is not the case for access-site events that typically occur in the aftermath of the index procedure.”

The percutaneous treatment of severe aortic valve disease using prosthetic aortic valve replacement, without the need for open-heart surgery or cardiopulmonary bypass, is faster and less invasive than current open-heart procedures. TAVR has so far been proven effective in high-risk and inoperable patients, and could soon become the standard of care, even in moderate and low surgical risk patients.

Related Links:
Swiss Cardiovascular Center Bern
University of Bern

Gold Member
12-Channel ECG
CM1200B
Gold Member
Solid State Kv/Dose Multi-Sensor
AGMS-DM+
Silver Member
Compact 14-Day Uninterrupted Holter ECG
NR-314P
New
Surgial Headlight
MedLED Chrome

Print article

Channels

Critical Care

view channel
Image: The permeable wearable electronics developed for long-term biosignal monitoring (Photo courtesy of CityUHK)

Super Permeable Wearable Electronics Enable Long-Term Biosignal Monitoring

Wearable electronics have become integral to enhancing health and fitness by offering continuous tracking of physiological signals over extended periods. This monitoring is crucial for understanding an... Read more

Patient Care

view channel
Image: The newly-launched solution can transform operating room scheduling and boost utilization rates (Photo courtesy of Fujitsu)

Surgical Capacity Optimization Solution Helps Hospitals Boost OR Utilization

An innovative solution has the capability to transform surgical capacity utilization by targeting the root cause of surgical block time inefficiencies. Fujitsu Limited’s (Tokyo, Japan) Surgical Capacity... Read more

Health IT

view channel
Image: First ever institution-specific model provides significant performance advantage over current population-derived models (Photo courtesy of Mount Sinai)

Machine Learning Model Improves Mortality Risk Prediction for Cardiac Surgery Patients

Machine learning algorithms have been deployed to create predictive models in various medical fields, with some demonstrating improved outcomes compared to their standard-of-care counterparts.... Read more

Point of Care

view channel
Image: The PATHFAST hs-cTnI-II high-sensitivity troponin assay has been developed for the PATHFAST Biomarker Analyzer (Photo courtesy of Polymedco)

POC Myocardial Infarction Test Delivers Results in 17 Minutes

Chest pain is the second leading cause of emergency department (ED) visits by adults in the United States, generating over 7 million visits annually. In the event of a suspected heart attack, physicians... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.