Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement

Siddiqui, Waqas Javed; Alvarez, Chikezie; Aslam, Muhammad Imran; Bakar, Khairul Azmi Abu; Khan, Muhammad Harisullah; Aslam, Ayesha; Hanif, Muhammad Owais; Hasni, Syed Farhan; Ranganna, Karthik; Eisen, Howard J.; Aggarwal, Sandeep

doi:10.1016/j.amjcard.2018.04.030

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…The 30-day mortality rate for patients with AKI following TAVR ranges from 7.8% to 29% compared to 2% to 15% for those without AKI 38. Similarly, after SAVR complicated with AKI, the 30-day mortality rate is between 5.5% and 46%, which is up to eightfold higher compared to SAVR free of AKI 37. Furthermore, post-TAVR AKI confers up to a fourfold increase in 1-year mortality, and the impact is still observed in a 3-year follow-up 39…”

Section: Risk Factorsmentioning

confidence: 97%

“…Data on AKI prevalence in TAVR patients vary between 3.4% and 57% with 0%–21% requiring renal replacement therapy (RRT) 3,4. Both high- and intermediate-risk patients have significantly lower AKI rates when compared to SAVR patients 5. Of note, data from German national database show an insignificant decline in the AKI rates after TAVR over time from 5.6% in 2007 to 5.2% in 2013 with a parallel significant increase after SAVR (from 2.4% in 2007 to 3.8% in 2013) 6.…”

Section: Diagnosis and Epidemiologymentioning

confidence: 99%

“…Among factors contributing to such an improvement, the authors outline experience in the procedure, patient qualification, and peri- and post-procedural care optimization. When compared to SAVR patients, the rates of RRT in TAVR patients are comparable, based on the data from a recent meta-analysis of randomized trials 37. However, in studies limited to patients with advanced CKD (≥stage 4), patients undergoing TAVR seem to require less RRT compared to those undergoing SAVR 20…”

Section: Risk Factorsmentioning

confidence: 99%

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<p>Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management</p>

Załęska‐Kocięcka¹,

Dąbrowski²,

Stępińska³

2019

CIA

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Aortic stenosis is the most common cause of valve replacement in Europe and North America with prevalence increasing with age. Transcatheter valve replacement (TAVR) represents an alternative for surgical valve replacement of severely stenotic valves. Despite lower risk of acute kidney injury compared to that associated with surgery, this complication remains prevalent in patients undergoing TAVR. There is a paucity of data confirming the relation of acute kidney injury with high morbidity and mortality, especially when superimposed on chronic kidney disease, which is a frequent comorbidity in the elderly with severe aortic stenosis. As there is no consensus on the prevention of acute kidney injury in patients undergoing TAVR, identification and limitation of risk factors are crucial. In this review, we aim to discuss the key aspects of acute kidney injury diagnosis, risk assessment, and outcomes in TAVR patients, and to point out gaps in current knowledge.

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Section: Risk Factorsmentioning

confidence: 97%

Section: Diagnosis and Epidemiologymentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

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<p>Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management</p>

Załęska‐Kocięcka¹,

Dąbrowski²,

Stępińska³

2019

CIA

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“…Impaired lung function, previous aortic valve surgery and a severe impairment of renal function at baseline predicted a higher likelihood of renal recovery, while diabetes mellitus, gender, age, anemia and a higher Society of thoracic risk score reduced the likelihood of a recovery [29][30][31]. Moreover, a recent metaanalysis showed improved renal outcomes using TAVI rather than surgical valve replacement despite the exposure to contrast media (CM) and a higher incidence of pacemaker implantations [32]. It is conceivable that improved hemodynamics after TAVI may have led to improvements in kidney perfusion as improved eGFR was accompanied by an increased…”

Section: Chronic Renal Failure Before Tavimentioning

confidence: 99%

Kidney injury as post-interventional complication of TAVI

et al. 2020

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Transcatheter aortic valve implantation (TAVI) is an accepted treatment approach of aortic stenosis. In the beginning, this technique was executed in high risk patients only. Today, intermediate risk patients are also amenable for TAVI, as long as the transfemoral approach is chosen. Numerous predictors have been identified that could lead to periprocedural complications and are defined by patient comorbidities as well as being inherent to the technical approach. Although vascular complications and postinterventional paravalvular regurgitation have been minimized over the past years by revised technologies and techniques, there is a prevailing individual risk brought about by the specific pathophysiology of the cardiorenal syndrome.

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“…Two recently published non-inferiority trials comparing TAVR to SAVR in the low-risk patient population also reported significantly reduced events of AKI in the TAVR arm [7,9]. We recently published a meta-analysis comparing TAVR with SAVR in patients with severe AS and reported their renal outcomes [10]. This is an updated meta-analysis of all the available randomized controlled trials (RCTs) to report AKI at 30 days and one year, and AKI requiring renal transplant in low-, intermediate-, and high-risk candidates.…”

Section: Introductionmentioning

confidence: 99%

Renal Injury in All-Comers After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Siddiqui

Sadaf

Zain

et al. 2020

Cureus

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BackgroundAcute kidney injury (AKI) following aortic valve replacement is associated with poor prognosis. Transcatheter aortic valve replacement (TAVR) is a novel strategy with a percutaneous approach and early recovery time. We conducted this meta-analysis to compare TAVR to surgical aortic valve replacement (SAVR) and their respective renal outcomes. MethodsWe searched for randomized controlled trials (RCTs) using MEDLINE, PUBMED, and Google Scholar databases from their inception till April 6, 2019, and included eight trials comparing TAVR to SAVR in cases that reported AKIs.

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Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement

Cited by 9 publications

References 27 publications

<p>Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management</p>

<p>Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management</p>

Kidney injury as post-interventional complication of TAVI

Renal Injury in All-Comers After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

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