• Hannah Dahn, Karen Buth, Jean-Francois Legare, Heather Mingo, Blaine Kent, Sara Whynot, and Matthias Scheffler.
• Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: Hannah.dahn@dal.ca.
• J. Cardiothorac. Vasc. Anesth. 2016 Jun 1; 30 (3): 687-91.

ObjectiveThis study sought to evaluate if the presence of endocarditis was independently associated with increased perioperative blood transfusion in patients undergoing aortic valve replacements (AVR) with aortic regurgitation.DesignThis was a retrospective study.SettingLarge Canadian tertiary care hospital.ParticipantsSix hundred sixty-two consecutive patients with aortic regurgitation score of 3 or higher undergoing AVR from 1995 to 2012.InterventionsNo interventions were performed in this retrospective study.Measurements And Main ResultsAfter REB approval, data were obtained from a center-specific database. Univariate analysis was performed to identify variables that may be associated with transfusion of any allogeneic blood product perioperatively. A multivariate logistic regression was generated to identify independent predictors of perioperative transfusion. Unadjusted transfusion rates in patients with no endocarditis and with endocarditis were 32% and 70% (p<0.001), respectively. Independent predictors of any transfusion were moderate-to-severe preoperative anemia, preoperative renal failure, non-isolated AVR, age>70, urgent/emergent surgery, BMI<25, and female sex. Endocarditis was not an independent predictor of transfusion (OR = 0.748; 95% CI = 0.35-1.601).ConclusionsIn patients undergoing AVR, unadjusted perioperative transfusion rates were higher when endocarditis was present. However, after adjustment, aortic valve endocarditis was not independently associated with blood transfusion. The authors' observation could be explained by the higher prevalence of many independent predictors of transfusion, such as comorbidities or more complex surgery, within the endocarditis group. Thus, AV endocarditis, in the absence of other risk factors, was not associated with increased perioperative transfusion risk.Copyright © 2016 Elsevier Inc. All rights reserved.

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