Risk of Bleeding in Elderly Patients Undergoing Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement
Federica Jiritano,
Giuseppe Filiberto Serraino,
Sabato Sorrentino,
Desirèe Napolitano,
Davide Costa,
Nicola Ielapi,
Umberto Marcello Bracale,
Pasquale Mastroroberto,
Michele Andreucci,
Raffaele Serra
Affiliations
Federica Jiritano
Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Giuseppe Filiberto Serraino
Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Sabato Sorrentino
Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Desirèe Napolitano
Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Davide Costa
Department of Law, Economics and Sociology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Nicola Ielapi
Interuniversity Center of Phlebolymphology (CIFL), “International Research and Educational Program in Clinical and Experimental Biotechnology” at the Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
Umberto Marcello Bracale
Department of Public Health, University Federico II of Naples, 80138 Napoli, Italy
Pasquale Mastroroberto
Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Michele Andreucci
Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Raffaele Serra
Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
Background: Bleeding complications are strong predictors of mortality and major morbidity in elderly patients undergoing surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Despite the high prevalence of frailty in this population, little is known about its effects on bleeding risk. Methods: We conducted a retrospective observational study of 502 patients undergoing isolated SAVR or TAVI between January 2015 and February 2022. The occurrence of blood products transfusions and MACEs were the primary endpoints. In-hospital mortality was the secondary endpoint. Results: The Elderly group (age p = 0.864; TAVI: Elderly group: 5.5% vs. Very Elderly group: 8.7%, p = 0.378]. The was no difference in in-hospital mortality rate in patients submitted to TAVI, whereas very elderly patients had higher mortality rate compared to the elderly patients submitted to SAVR [SAVR: Elderly group: 0% vs. Very Elderly group: 2.8%, p = 0.024; TAVI: Elderly group: 4,8% vs. Very Elderly group: 8%, p = 0.389]. Conclusions: Age alone should not be considered as a predictive factor for post-operative adverse events or in-hospital mortality in elderly patients with severe symptomatic AS.
