Incidence of postoperative acute kidney injury in patients with chronic kidney disease undergoing minimally invasive valve surgery

Valdez, Gerson D.; Mihos, Christos G.; Santana, Orlando; Heimowitz, Todd; Goldszer, Robert C.; Lamas, Gervasio A.; Lamelas, Joseph

doi:10.1016/j.jtcvs.2013.06.034

Cited by 16 publications

(11 citation statements)

References 23 publications

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“…Lamelas et al have compared the outcomes of minimally invasive valve surgery with median sternotomy in high risk patients, (9) Lamelas have demonstrated a reduced morbidity and lower resource utilization in those patients with chronic kidney disease, (10) chronic obstructive pulmonary disease, (11) those requiring reoperative mitral valve (12) and aortic valve (13) surgery. In addition, they observed a reduction in mortality in the elderly (14) and obese (15) patients.…”

Section: Discussionmentioning

confidence: 99%

The Minimally Invasive Right Vertical Infra-axillary Lateral Minithoracotomy Approach For The Heart Valve Surgery: Report of 115 Cases

Turgut¹,

Kaso²,

Akyıldız³

et al. 2016

ejcm

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Objective:We have developed a minimally invasive technique for heart valve replacements through a lateral minithoracotomy via a small right infra-axillary skin incision, and have evaluated its initial results. Methods:Through right vertical infra-axillary lateral minithoracotomy incision (by third intercostal space), 106 patients with rheumatic heart valve disease underwent heart valve surgery, 4 patients with left atrial myxsoma and 5 patient with large atrial septal defect underwent open heart operation are included in this study from July 2012 to December 2015.Results: 42 isolated mitral valve replacements, 7 mitral valve replacements and DeVega tricuspid annuloplasty, 3 mitral and tricuspid valve replacement, 2 mitral valve replacement and right coronary artery bypass graft, 1 reoperative mitral valve replacement due to dejeneration of the bioprothesis of the mitral valve, 6 mitral valve repair, 1 mitral valve repair and aortic valve replacement; 33 isolated aortic valve replacements, 9 aortic and mitral double valve replacements, 2 triple valve replacements, 4 excision of the left atrial myxsoma and 5 surgical closure of the large atrial septal defect were performed. There were 52 women (45%) and 63 men (55%). The mean and range of age was 48±9 (14-91). The length of the incision averaged 8.5±0.5 cm, There were 4 operative mortalities, one patient from infective endocarditis and multisystem organ failure, the other patients from cardiac failure in the hospital. The results of follow up for other patients were fine. Conclusions:This minimally invasive right vertical infra-axillary lateral minithoracotomy approach is safely, practicable, useful, economic, small wounded, cosmetic, contemporary and modern approach for the heart valve surgery Keywords: infra-axillary, minithoracotomy, minimally-invasive cardiac surgery Abstract

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Section: Discussionmentioning

confidence: 99%

The Minimally Invasive Right Vertical Infra-axillary Lateral Minithoracotomy Approach For The Heart Valve Surgery: Report of 115 Cases

Turgut¹,

Kaso²,

Akyıldız³

et al. 2016

ejcm

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“…Also, we identified the use of minimally invasive surgery, which was the predominant surgical technique in our study population, to be associated with a low prevalence of AKI; this is likely because of the low risk of postoperative complications and blood transfusion requirement, lower risk of postoperative systemic immune inflammatory syndrome, accelerated recovery, and low use of potential nephrotoxic medications (e.g., non-steroidal anti-inflammatory drugs) [32]. Reports have indicated the noninferiority of this approach to conventional surgery [33], and recent guidelines recommend minimally invasive surgical procedures where expertise is available with an IIa class of recommendation (33).…”

Section: Relationship With Previous Studiesmentioning

confidence: 99%

Use of minimally invasive surgery and therapies mitigating pulmonary arterial pressure and intraoperative blood loss may offer protection against cardiac surgery-associated acute kidney injury

Husain‐Syed

Quattrone²,

Ferrari

et al. 2020

Preprint

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Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased morbidity and mortality. We aimed to identify potentially modifiable risk factors for CSA-AKI.Methods: This was a single-center retrospective cohort study of 495 adult patients undergoing cardiac surgery. AKI was diagnosed and staged using full KDIGO criteria incorporating baseline serum creatinine (SC) levels and correction of postoperative SC levels for fluid balance. We examined the association of routinely available clinical and laboratory data with AKI using multivariate logistic regression modeling.Results: A total of 103 (20.8%) patients developed AKI: 16 (15.5%) patients were diagnosed with AKI upon hospital admission, and 87 (84.5%) patients were diagnosed with CSA-AKI. Correction of SC levels for fluid balance increased the number of AKI cases to 104 (21.0%), with six patients categorized to different AKI stages. Univariate logistic regression analysis identified five preoperative (age, sex, diabetes mellitus, preoperative systolic pulmonary arterial pressure (PSPAP), acute decompensated heart failure) and five intraoperative predictors of AKI (age, sex, red blood cell (RBC) volume transfused, use of minimally invasive surgery, duration of cardiopulmonary bypass). When all preoperative and intraoperative variables were incorporated into one model, six predictors remained significant (age, sex, use of minimally invasive surgery, RBC volume transfused, PSPAP, duration of cardiopulmonary bypass). Model-discrimination performance showed an area under the curve of 0.69 for the model including only preoperative variables, 0.76 for the model including only intraoperative variables, and 0.77 for the model including all preoperative and intraoperative variables.Conclusions: Use of minimally invasive surgery and therapies mitigating PSPAP and intraoperative blood loss may offer protection against CSA-AKI. Trial Registration: www.ClinicalTrials.gov (NCT03102528)

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“…Valdez et al, evaluated the outcomes of 688 patients with chronic kidney disease stages 2-5, who had isolated aortic or MV surgery (63). The results of 510 who had MIVS via a right thoracotomy were compared with 178 who had ST. Baseline characteristics were similar, with the exception of older age in the MIVS group (MIVS 71.3±11.6 years, ST 67.8±12 years, P=0.001).…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Minimally invasive valve surgery in high-risk patients

et al. 2017

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The use of minimally, or less invasive, approaches to cardiac valve surgery has increased over the past decade. Because of its less traumatic nature, early studies in lower risk patients demonstrated the approach to be associated with an enhanced recovery, increased patient satisfaction, and good operative outcomes. With time, despite a steep learning curve, surgeons expanded this approach to perform more complex procedures, and include patients with more co-morbidity. The aim of this publication is to review the current literature involving the use of minimally invasive valve surgery (MIVS) in higher-risk patients.

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Incidence of postoperative acute kidney injury in patients with chronic kidney disease undergoing minimally invasive valve surgery

Abstract: In patients with CKD undergoing isolated valve surgery, minimally invasive valve surgery is associated with reduced postoperative complications and lower resource use.

Cited by 16 publications

References 23 publications

The Minimally Invasive Right Vertical Infra-axillary Lateral Minithoracotomy Approach For The Heart Valve Surgery: Report of 115 Cases

The Minimally Invasive Right Vertical Infra-axillary Lateral Minithoracotomy Approach For The Heart Valve Surgery: Report of 115 Cases

Use of minimally invasive surgery and therapies mitigating pulmonary arterial pressure and intraoperative blood loss may offer protection against cardiac surgery-associated acute kidney injury

Minimally invasive valve surgery in high-risk patients

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