Late Adverse Cardiorenal Events of Catheter Procedure-Related Acute Kidney Injury After Transcatheter Aortic Valve Implantation

Adachi, Yuya; Yamamoto, Masanori; Shimura, Tetsuro; Yamaguchi, Ryo; Kagase, Ai; Tokuda, Takahiko; Tsujimoto, Satoshi; Kōyama, Yutaka; Otsuka, Toshiaki; Yashima, Fumiaki; Tada, Norio; Naganuma, Toru; Araki, Motoharu; Yamanaka, Futoshi; Shirai, Shinichi; Mizutani, Kazuki; Tabata, Minoru; Ueno, Hiroshi; Takagi, Kensuke; Watanabe, Yusuke; Hayashida, Kentaro; Investigators, Ocean-Tavi

doi:10.1016/j.amjcard.2020.07.041

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Patients with emergent TAVI might receive CT angiography and cardiac catheterization within a short time before surgery [ 10 ]. And contrast medium was considered an important factor of renal injury during TAVI [ 34 ]. Bleeding and postprocedural AR, which were more common in emergent TAVI patients, were also reported to be associated with AKI after TAVI [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Emergent Transcatheter Aortic Valve Implantation in Patients with Acute Decompensated Aortic Stenosis: Systematic Review and Meta-Analysis

Shao

et al. 2021

Journal of Interventional Cardiology

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Introduction. The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of emergent transcatheter aortic valve implantation (TAVI) in patients with decompensated aortic stenosis (AS) by comparing the clinical outcomes with the patients who had received the elective TAVI. Methods. By searching PubMed, EMBASE, and Cochrane databases, we obtained the studies comparing the clinical outcomes of emergent TAVI and elective TAVI. Finally, 14 studies were included. Results. A total of 14 eligible articles with 73,484 patients were included in this meta-analysis. Emergent TAVI was associated with a higher mortality during hospitalization (HR 2.09, 95% CI [1.39 to 3.14]), 30 days (HR 2.29, 95% CI [1.69 to 3.10]), and 1 year (HR 1.96, 95% CI [1.55 to 2.49]). Consistently, the incidence of acute kidney injury (AKI) (RR 2.48, 95% CI [1.85 to 3.32]), dialysis (RR 2.37, 95% CI [1.95 to 2.88]), bleeding (RR 1.62, 95% CI [1.27 to 2.08]), major bleeding (RR 1.05, 95% CI [1.00 to 1.10]), and 30-day rehospitalization (RR 1.30, 95% CI [1.07, 1.58]) were more common in patients receiving emergent TAVI. No statistical differences were found in the occurrence rate of vascular complications (RR 1.11, 95% CI [0.90, 1.36]), major vascular complications (RR 1.14, 95% CI [0.52, 2.52]), permanent pacemaker (PPM) placement (RR 1.05, 95% CI [0.99, 1.11]), cerebrovascular events (RR 1.11, 95% CI [0.98, 1.25]), moderate to severe paravalvular leakage (PVL) (RR 1.23, 95% [CI 0.94 to 1.61]), and device success (RR 0.99, 95% CI [0.97, 1.01]). Conclusion. Emergent TAVI is associated with some postoperative complications and increased mortality compared with elective TAVI. Emergent TAVI should be implemented cautiously and individually.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Emergent Transcatheter Aortic Valve Implantation in Patients with Acute Decompensated Aortic Stenosis: Systematic Review and Meta-Analysis

Shao

et al. 2021

Journal of Interventional Cardiology

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“…Prior studies showed that TAVI can bring about improvements in renal function 6 but may also be complicated by kidney injury which is a risk factor for prognosis. 7 , 8 , 9 However, liver function is underappreciated, with a few studies focusing on liver function only in patients with pre‐existing liver diseases. 10 , 11 , 12 , 13 Despite many studies emphasizing the prognostic value of the combination of renal and liver function on varied types of cardiac pathologies, 14 , 15 , 16 , 17 , 18 , 19 , 20 there is a paucity of data on TAVI.…”

Section: Introductionmentioning

confidence: 99%

“…Transcatheter aortic valve implantation (TAVI) is currently the guideline‐recommended therapy for patients with severe AS, 4,5 and it has the potential to break this vicious cycle by relieving aortic valve obstruction. Prior studies showed that TAVI can bring about improvements in renal function 6 but may also be complicated by kidney injury which is a risk factor for prognosis 7–9 . However, liver function is underappreciated, with a few studies focusing on liver function only in patients with pre‐existing liver diseases 10–13 .…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of the dynamic hepatorenal function on intermediate‐term mortality in TAVI patients with survival to discharge

Yao

Xiong

et al. 2022

Clinical Cardiology

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Background Renal and liver dysfunctions are risk factors for mortality in patients with severe aortic stenosis (AS). Transcatheter aortic valve implantation (TAVI) has the potential to break the vicious cycle between AS and hepatorenal dysfunction by relieving aortic valve obstruction. Hypothesis A part of patients can derive hepatorenal function improvement from TAVI, and this noncardiac benefit improves the intermediate‐term outcomes. Methods We developed this retrospective cohort study in 439 consecutive patients undergoing TAVI and described the dynamic hepatorenal function assessed by model for end‐stage liver disease model for end‐stage liver disease (MELD)‐XI score in subgroups. The endpoint was 2‐year all‐cause mortality. Results Receiver‐operating characteristic analysis showed that the baseline MELD‐XI score of 10.71 was the cutoff point. A high MELD‐XI score (>10.71) at baseline was an independent predictor of the 2‐year mortality hazard ratio (HR: 2.65 [1.29–5.47], p = .008). After TAVI, patients with irreversible high MELD‐XI scores had a higher risk of 2‐year mortality than patients who improved from high to low MELD‐XI scores (HR: 2.50 [1.06–5.91], p = .03). Factors associated with reversible MELD‐XI scores improvement were low baseline MELD‐XI scores (≤12.00, odds ratio [OR]: 2.02 [1.04–3.94], p = .04), high aortic valve peak velocity (≥5 m/s, OR: 2.17 [1.11–4.24], p = .02), and low body mass index (≤25 kg/m 2 , OR: 2.73 [1.25–5.98], p = .01). Conclusion High MELD‐XI score at baseline is an independent predictor for 2‐year mortality. Patients with hepatorenal function improvement after TAVI have better outcomes. For patients with irreversible hepatorenal dysfunction after TAVI, further optimization of the subsequent treatment after TAVI is needed to improve the outcomes.

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Chronic kidney disease and transcatheter aortic valve implantation

Adachi

Yamamoto

2022

Cardiovasc Interv and Ther

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Late Adverse Cardiorenal Events of Catheter Procedure-Related Acute Kidney Injury After Transcatheter Aortic Valve Implantation

Cited by 5 publications

References 19 publications

Efficacy and Safety of Emergent Transcatheter Aortic Valve Implantation in Patients with Acute Decompensated Aortic Stenosis: Systematic Review and Meta-Analysis

Efficacy and Safety of Emergent Transcatheter Aortic Valve Implantation in Patients with Acute Decompensated Aortic Stenosis: Systematic Review and Meta-Analysis

Prognostic value of the dynamic hepatorenal function on intermediate‐term mortality in TAVI patients with survival to discharge

Chronic kidney disease and transcatheter aortic valve implantation

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