How does major bleeding influence decision-making in patients eligible for transfemoral TAVI? A single-center experience.

Authors

Carmen Vidau Getán, Domingo López Vázquez, Xacobe Flores Ríos, Borja Souto Caínzos, Fernando Rebollal Leal, Pablo Piñón Esteban, Guillermo Aldama López, Jorge Salgado Fernández, Miguel González Montes, Gabriel González Barbeito, Ramón Calviño Santos, José Manuel Vázquez Rodríguez

Published in

REC, interventional cardiology. Volume 8. Issue 2. Pages 79-84. Epub Dec 14, 2025.

Abstract

To evaluate the impact of bleeding on the risk-benefit balance of coronary revascularization prior to transfemoral transcatheter aortic valve implantation (TF-TAVI).
We conducted a retrospective analysis of the patients who underwent TF-TAVI at our center between 2008 and 2018 to evalute the management of coronary artery disease (percutaneous revascularization vs no revascularization). Subsequently, the rate of major bleeding -defined according to the Bleeding Academic Research Consortium (BARC) criteria (type 3-5)- and major adverse cardiovascular events (MACE) was compared between the 2 groups over a mean 60-month follow-up period.
A total of 379 patients were included. The overall rate of major bleeding was 21.4%, higher in revascularized patients but without reaching statistical significance. The rate of major bleeding between coronary angiography and TF-TAVI implantation was 5.5% and significantly higher in revascularized patients (12.0% vs 3.5%; P = .07). During the hospitalization for TF-TAVI and throughout follow-up, the rate of major bleeding was 6.1% and 9.6%, respectively, with no significant inter-group differences. There were no significant differences either in the 5-year rate of MACE.
In our patient cohort, pre-TF-TAVI preoperative coronary revascularization was associated with an initially higher bleeding risk; however, no statistically significant differences were observed in major bleeding or MACE at the 5-year follow-up. These findings support the need to generate high-quality clinical evidence to demonstrate the net clinical benefit of coronary revascularization in this context.

PMID:
42745728
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.

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