Incidence, risk factors, and outcomes of acute kidney injury in adults undergoing surgery for congenital heart disease

Kwiatkowski, David M.; Price, Elizabeth; Axelrod, David M.; Romfh, Anitra; Han, Brian; Sutherland, Scott M.; Krawczeski, Catherine D.

doi:10.1017/s1047951116002067

Cited by 21 publications

(21 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our overall lower rate of AKI may have been because of excluding patients greater than 40 years of age. Kwiatkowski and colleagues [22] did not find an association of the nephrotoxic medications that they explored with AKI. However, notably, there was a smaller number of patients receiving vancomycin (11 versus 87), ACE inhibitors (6 versus 60), and NSAIDs (26 versus 186) when compared with our patient cohort [22].…”

Section: Commentmentioning

confidence: 92%

“…Kwiatkowski and colleagues [22] did not find an association of the nephrotoxic medications that they explored with AKI. However, notably, there was a smaller number of patients receiving vancomycin (11 versus 87), ACE inhibitors (6 versus 60), and NSAIDs (26 versus 186) when compared with our patient cohort [22]. They did not include the postoperative use of calcineurin inhibitors, antiviral medications, cephalosporins, or diuretics in their analysis.…”

Section: Commentmentioning

confidence: 92%

“…Despite the increase in the number young adults living with CHD because of significant advances in their medical and surgical care, there is a lack of literature on the incidence and impact of AKI in this patient group. In a single-center retrospective cohort study of 118 patients, Kwiatkowski and colleagues [22] reported an AKI rate of 36% in patients greater than or equal to 18 years of age with a history of CHD after CPB exposure. Our overall lower rate of AKI may have been because of excluding patients greater than 40 years of age.…”

Section: Commentmentioning

confidence: 99%

See 2 more Smart Citations

Postoperative Acute Kidney Injury in Young Adults With Congenital Heart Disease

Fuhrman

Nguyen

Sanchez‐de‐Toledo

et al. 2019

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Section: Commentmentioning

confidence: 92%

Section: Commentmentioning

confidence: 92%

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Postoperative Acute Kidney Injury in Young Adults With Congenital Heart Disease

Fuhrman

Nguyen

Sanchez‐de‐Toledo

et al. 2019

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

“…22,23 An increase in creatinine of at least 0.3 mg/dL, per kidney disease: improving global outcome definition, constituted acute kidney injury. 27,28 Infection constituted any presumed infection, including clinical sepsis, colitis, pancreatitis, pneumonia, or sternal infection necessitating antibiotic treatment.…”

Section: Definitionsmentioning

confidence: 99%

Short‐term outcomes of en bloc combined heart and liver transplantation in the failing Fontan

Vaikunth

Concepción

Daugherty

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

Patients with failing Fontan physiology and liver cirrhosis are being considered for combined heart and liver transplantation. We performed a retrospective review of our experience with en bloc combined heart and liver transplantation in Fontan patients > 10 years old from 2006 to 18 per Institutional Review Board approval. Six females and 3 males (median age 20.7, range 14.2-41.3 years) underwent en bloc combined heart and liver transplantation. Indications for heart transplant included ventricular dysfunction, atrioventricular valve regurgitation, arrhythmia, and/or lymphatic abnormalities. Indication for liver transplant included portal hypertension and cirrhosis. Median Fontan/single ventricular end-diastolic pressure was 18/12 mm Hg, respectively. Median Model for End-Stage Liver Disease excluding International Normalized Ratio score was 10 (7-26), eight patients had a varices, ascites, splenomegaly, thrombocytopenia score of ≥ 2, and all patients had cirrhosis. Median cardiopulmonary bypass and donor ischemic times were 262 (178-307) and 287 (227-396) minutes, respectively. Median intensive care and hospital stay were 19 (5-96) and 29(13-197) days, respectively. Survival was 100%, and rejection was 0% at 30 days and 1 year post-transplant. En bloc combined heart and liver transplantation is an acceptable treatment in the failing Fontan patient with liver cirrhosis.

show abstract

“…The team believed surgical palliation conferred high operative risk because of the combination of: atrioventricular valve regurgitation (7,8); longstanding pre-operative cyanosis; pre-operative arrhythmia; New York Heart Association (NYHA) class IV (18); potential for post-operative bleeding requiring re-exploration (19); dilated systemic ventricle (20); potential for post-operative acute kidney injury (21); and aorto-pulmonary collateral burden. Pre-procedure hemoglobin was 19.3 g/dl, hematocrit was 61.9%, blood urea nitrogen was 12 mg/dl, and creatinine was 0.6 mg/dl.…”

Section: Methodsmentioning

confidence: 99%

First-in-Human Closed-Chest Transcatheter Superior Cavopulmonary Anastomosis

Ratnayaka

Moore

Rios

et al. 2017

Journal of the American College of Cardiology

View full text Add to dashboard Cite

BACKGROUND In the care of patients with congenital heart disease, percutaneous interventional treatments have supplanted many surgical approaches for simple lesions, such as atrial septal defect. By contrast, complex congenital heart defects continue to require open-heart surgery. In single-ventricle patients, a staged approach is employed, which requires multiple open-heart surgeries and significant attendant morbidity and mortality. A nonsurgical transcatheter alternative would be attractive. OBJECTIVES We sought to show the feasibility of catheter-only, closed-chest, large-vessel anastomosis (superior vena cava and pulmonary artery [PA] or bidirectional Glenn operation equivalent) in a patient. METHODS In preclinical testing over a decade, we developed the techniques and technology needed for nonsurgical crossing from a donor (superior vena cava) to a recipient (PA) vessel and endovascular stent-based anastomosis of those blood vessels. We undertook this transcatheter approach for an adult with untreated congenital heart disease with severe cyanosis and significant surgical risk. We rehearsed the procedure step by step using contrast-enhanced cardiac computed tomography and a patient-specific 3-dimensional printed heart model. RESULTS We described a first-in-human, fully percutaneous superior cavopulmonary anastomosis (bidirectional Glenn operation equivalent). The patient, a 35-year-old woman, was homebound due to dyspnea and worsening cyanosis. She was diagnosed with functional single ventricle and very limited pulmonary blood flow. The heart team believed surgical palliation conferred high operative risk due to the patient’s complete condition. With the percutaneous procedure, the patient suffered little morbidity and remained improved clinically after 6 months. CONCLUSIONS This procedure may provide a viable alternative to one of the foundational open-heart surgeries currently performed to treat single-ventricle congenital heart disease.

show abstract

Incidence, risk factors, and outcomes of acute kidney injury in adults undergoing surgery for congenital heart disease

Cited by 21 publications

References 29 publications

Postoperative Acute Kidney Injury in Young Adults With Congenital Heart Disease

Postoperative Acute Kidney Injury in Young Adults With Congenital Heart Disease

Short‐term outcomes of en bloc combined heart and liver transplantation in the failing Fontan

First-in-Human Closed-Chest Transcatheter Superior Cavopulmonary Anastomosis

Contact Info

Product

Resources

About