• Christopher Adlbrecht, Felix Piringer, Jon Resar, Victoria Watzal, Martin Andreas, Andreas Strouhal, Waseem Hasan, Daniela Geisler, Gabriel Weiss, Martin Grabenwöger, Georg Delle-Karth, and Markus Mach.
• Vienna North Hospital - Clinic Floridsdorf and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research Vienna, Vienna, Austria.
• Eur. J. Clin. Invest. 2020 Apr 22; 50 (8): e13251e13251.

BackgroundWe investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction.Materials And MethodsWe retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centres. They were then categorized into two groups depending on their preoperative PVS (PVS ≤-4; n = 257 vs PVS>-4; n = 379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1 - haematocrit) × (a + (b × weight in kg)).ResultsThe need for renal replacement therapy (1 (0.4%) vs 17 (4.5%); P = .001), re-operation for noncardiac reasons (9 (3.5%) vs 32 (8.4%); P = .003), re-operation for bleeding (9 (3.5%) vs 27 (7.1%); P = .037) and major bleeding (14 (5.4%) vs 37 (9.8%); P = .033) were significantly higher in patients with a PVS>-4. The composite 30-day early safety endpoint (234 (91.1%) vs 314 (82.8%); P = .002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI.ConclusionsAn elevated PVS (>-4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification.© 2020 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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