Transcatheter aortic valve implantation in Jehovah's Witness patients with symptomatic severe aortic valve stenosis
German Heart Institute Berlin, Berlin, Germany.Interactive Cardiovascular and Thoracic Surgery (Impact Factor: 1.16). 06/2012; 15(4):766-8. DOI: 10.1093/icvts/ivs216
Transcatheter aortic valve implantation (TAVI) is currently reserved for high or prohibitive surgical-risk patients with aortic valve stenosis. We report on successful TAVI in two Jehovah's witness patients. It offers a simple and effective treatment of severe aortic valve stenosis in high-risk patients who refuse the use of allogeneic blood and blood products. © 2012 The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
- [Show abstract] [Hide abstract]
ABSTRACT: Background: Transcatheter aortic valve replacement (TAVR) is less invasive than surgical aortic valve replacement and may be preferred for patients, who refuse blood transfusions. Objectives: Our study sought to define transfusion rates in TAVR, identify predictors and develop recommendations for patients, who refuse transfusions. Methods: A large cohort of consecutive patients undergoing TAVR was prospectively studied. Blood loss and transfusion rates were observed in patients undergoing transfemoral (TF-TAVR) and transapical TAVR (TA-TAVR). Predictors for transfusion were investigated in a multivariate model. Results: Of 373 consecutive patients, 270 underwent TF-TAVR and 103 TA-TAVR. Transfusion rates were significantly lower in TF-TAVR than TA-TAVR (11.1 % versus 41.7 %; p < 0.001). In patients who did not receive transfusions, blood loss was significantly lower in TF-TAVR than TA-TAVR (23.6 ± 12.2 g/l versus 28.9 ± 13.7 g/l; p = 0.004), but did not differ in transfused patients (36.9 ± 12.9 g/l versus 33.4 ± 21.2 g/l; p = 0.428). Predictors for transfusions were low baseline hemoglobin, female sex, low body weight and decreased renal function. In 7 Jehovah's Witness patients, who refuse transfusions, no vascular complications occurred and clinical outcome was excellent. Conclusion: In patients, who refuse transfusions, TAVR may be performed with good clinical outcomes provided a high baseline hemoglobin level, careful management of the access site and strict measurements to reduce blood loss. TF-TAVR is associated with less blood loss and a lower rate of transfusions than TA-TAVR, and may be the preferred option for patients, who refuse transfusions. © 2014 Wiley Periodicals, Inc.Catheterization and Cardiovascular Interventions 05/2014; 83(6). DOI:10.1002/ccd.25389 · 2.11 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.