Transfemoral transcatheter aortic valve implantation in patients with end-stage renal disease and kidney transplant recipients

Al–Rashid, Fadi; Bienholz, Anja; Hildebrandt, Heike; Patsalis, Polykarpos; Totzeck, Matthias; Kribben, Andreas; Wendt, Daniel; Jakob, Heinz; Lind, Alexander; Jánosi, Rolf Alexander; Rassaf, Tienush

doi:10.1038/s41598-017-14486-7

Cited by 17 publications

(18 citation statements)

References 26 publications

(29 reference statements)

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“…Fox et al reported minimal complications following TAVR in a small sample of 26 KT recipients comparing TAVR with surgical repair (one stroke at 12 months following TAVR) [88]. On the other hand, Al-Rashid et al reported a series of cases from a single center in Germany in which KT recipients experienced a 2-year mortality following TAVR of 53%, as compared with 31% in patients with open surgical repair [89]. Larger studies will be needed to identify more reliable estimates of outcomes following TAVR in KT recipients.…”

Section: A L V U L a R H E A R T D I S E A S E I N T H E K I D N E Y T R A N S P L A N T R E C I P I E N Tmentioning

confidence: 99%

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Rangaswami

Mathew

Parasuraman

et al. 2019

Nephrology Dialysis Transplantation

140

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Section: A L V U L a R H E A R T D I S E A S E I N T H E K I D N E Y T R A N S P L A N T R E C I P I E N Tmentioning

confidence: 99%

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Rangaswami

Mathew

Parasuraman

et al. 2019

Nephrology Dialysis Transplantation

140

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“…Satisfactory early results have been achieved with TAVI in Japanese dialysis patients with a high surgical risk [16]. TAVI is feasible not only in patients with CKD stage G5D but also in kidney transplant recipients [5]. However, depending on the prosthesis, 8.5 to 25.9% of patients undergoing TAVI require a permanent pacemaker within 30 days after the procedure [17].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, there is no information as to whether patients underwent HD via an AVF/ arteriovenous graft, a tunneled central catheter or arterial superficialization in the studies. The mortality rates in the short-term (30 days/1 year) and long-term (2 years/3 years) periods after TAVI are 0 to 15.2%/0 to 45.2% and 53%/73.2%, respectively [5,15,23,[25][26][27][28][29]. At present, the Japanese healthcare system does not reimburse TAVI for dialysis patients.…”

Section: The Impact Of Tavi In Dialysis Patientsmentioning

confidence: 99%

“…The relative survival after TAVI is high, and survival rates in those aged > 85 years are approximately those of a matched general population within 3 years [3]. TAVI is feasible in patients with not only chronic kidney disease (CKD) stage G3-5 [4] but also CKD stage G5D [5]. However, it is not known whether TAVI is safe and beneficial for the creation of AVF in old patients with severe AS shortly after initiating acute HD using a venous catheter.…”

Section: Introductionmentioning

confidence: 99%

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A 91-year-old woman with severe aortic stenosis successfully underwent maintenance hemodialysis via arteriovenous fistula after transcatheter aortic valve implantation: a case report with literature review

et al. 2019

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Background: Transcatheter aortic valve implantation (TAVI) has evolved to be a treatment of choice in high-risk patients with aortic stenosis (AS). However, it is not known whether TAVI is safe and beneficial for the creation of arteriovenous fistula for maintenance hemodialysis in high-risk patients with severe AS. Case presentation: A 91-year-old woman was referred to our hospital due to oligoanuria and progressive renal dysfunction. She was diagnosed with anti-glomerular basement membrane (GBM) disease. She had hypertension, chronic kidney disease stage G3b, and AS. We chose not to perform immunosuppressive therapy and plasmapheresis for anti-GBM disease because the risk of death outweighed the benefit of treatment. Hemodialysis with a venous catheter was initiated for the renal indication. As she showed severe AS, she had a risk of cardiac decompensation after arteriovenous fistula creation for dialysis. Following the clinical decision-making process, she underwent TAVI. Although she required the implantation of a cardiac pacemaker for an advanced atrioventricular block that occurred 11 days after TAVI, arteriovenous fistula was successfully created thereafter. She could undergo maintenance hemodialysis using arteriovenous fistula. Conclusions: TAVI is safe and beneficial for the creation of arteriovenous fistula shortly after initiating acute hemodialysis using a catheter in a very old patient with anti-GBM disease.

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“…A transzkatéteres billentyűátültetés (TAVI) hatékonyságáról TXs betegek körében megoszlanak a korai vizsgálatok eredményei. Fox és mtsai 26 TXs TAVIn átesett betegnél 1 alkalom mal tapasztalták stroke kialakulását [18], míg egy német centrumban a 2 éves mortalitás vesetranszplantációs TAVIn átesett betegek körében 53%os volt, a hagyo mányos sebészi technikával implantált műbillentyűsök között viszont csak 31% [19].…”

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A vesetranszplantáció korai posztoperatív hatásai a szív- és érrendszeri betegségekre klinikai gyakorlatunkban

Daragó

Schwegler

Szabó

et al. 2021

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Összefoglaló. Bevezetés: Mind a dializált, mind a veseátültetett betegek körében vezető haláloknak számít a cardiovascularis megbetegedés. E mögött főképp bal kamrai hypertrophia, volumenterheltség, következményes szívritmuszavar, szívbillentyű-elégtelenség, fokozott atherosclerosis állhat. Célkitűzés: Célunk a vesetranszplantáció hatásának vizsgálata a bal kamra pumpafunkciójára, a szívritmuszavarokat kiváltó és meghatározó tényezőkre és a vitiumokra nézve. Módszerek: A 2014. december 20. és 2018. június 21. közti időintervallumban, a Debreceni Egyetem Szervtranszplantációs Tanszékén felnőtt betegeken végzett veseátültetéseket vizsgáltuk retrospektív analízissel (n = 184). Vesetranszplantációt megelőzően, illetve azt követően 6 és 12 hónappal az echokardiográfiás, a laboratóriumi és a gyógyszeres terápiás értékeket tanulmányoztuk. A statisztikai elemzéseket khi-négyzet-próbával, Fisher-féle egzakt teszttel és Kruskal–Wallis-féle varianciaanalízissel (ANOVA) végeztük (szignifikancia: p<0,05). Eredmények: A bal kamra végsystolés tágassága az átültetés előtt 34,67 mm volt, míg a 6 hónapos eredmény 31,82 mm, a 12 hónapos 32,68 mm volt (p = 0,01). Átültetés előtt a stroke prevalenciája 7,87% volt, míg a beavatkozás után nem fordult elő szélütés (p<0,001). Transzplantáció hatására a bal pitvari átmérő (43,68 mm; 41,59 mm; 41,00 mm; p = 0,0417) és a káliumszint (4,98 mmol/l; 4,49 mmol/l; 4,49 mmol/l; p = 0,01) szignifikáns változást igazolt. Műtét előtt II. fokú mitralis regurgitatiót észleltünk 10,7%-nál, mely 4,3%-ra, majd 2,1%-ra csökkent (p = 0,03). Transzplantációt megelőzően a billentyűmeszesedés előfordulása diabetesesek között 45% (p = 0,20), 6 hónap múlva 46,7% (p = 0,018), 12 hónap múlva 60,0% (p = 0,024) volt. Következtetés: Transzplantáció után a bal pitvari átmérő, a végsystolés bal kamrai átmérő regrediál, csökken a pitvari ritmuszavarok kialakulásának gyakorisága. A mitralis regurgitatio közepesen súlyos fokainál szignifikáns javulást, a diabeteses populáción belül szignifikáns emelkedést tapasztaltunk a meszes billentyűk számát tekintve. Orv Hetil. 2021; 162(26): 1052–1062. Summary. Introduction: Among the population suffering from end-stage renal failure and the population after kidney transplantation, the leading reason of death is cardiovascular triggered by left ventricular hypertrophy, volume overload, consecutive arrhythmias, valvular insufficiency and increased artherosclerosis. Objective: This study was aimed at examining the effect of kidney transplantation on pump function of the left ventricle, arrhythmic substrates and valvular heart diseases. Methods: At the Division of Organ Transplantation, University of Debrecen, we carried out a retrospective data analysis of adult patients (n = 184) who had kidney transplantation in the period between December 2014 and June 2018. Preoperatively and, then, postoperatively (at 6 and 12 months) we studied the echocardiographic parameters, the laboratory results. Statistical analyses were performed using the chi-square/Fisher’s exact test and Kruskal–Wallis analysis of variance (ANOVA) test. The results were regarded significant if p<0.05 was found. Results: Preoperatively the end-systolic diameter of the left ventricle was 34.67 mm, whereas 6 and 12 months later these values were 31.82 mm and 32.68 mm (p = 0.01). The prevalence of stroke was 7.87% preoperatively; there was no stroke detected postoperatively (p<0.001). The impact of transplantation on the left atrial diameter (43.68 mm; 41.59 mm; 41.00 mm; p = 0.04) and seral potassium level (4.98 mmol/l; 4.49 mmol/l; 4.49 mmol/l; p<0.01) showed significant improvement. Before transplantation, grade 2 mitral regurgitation was observed in 10.7% of the patients, whereas it reduced to 4.3%, then to 2.1% 6 and 12 months postoperatively (p = 0.03). Preoperative valvular calcification was detected in 45% of the diabetic study population (p = 0.20), 6 and 12 months later, in 46.7% (p = 0.018) and 60.0% (p = 0.024). Conclusion: After transplantation, the left atrial and the end-systolic diameter of the left ventricle regrediated, decreasing the frequency of arrhythmic episodes. The number of the middle grade mitral valve regurgitation decreased and the calcification among diabetic population increased significantly. Orv Hetil. 2021; 162(26): 1052–1062.

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Transfemoral transcatheter aortic valve implantation in patients with end-stage renal disease and kidney transplant recipients

Cited by 17 publications

References 26 publications

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

A 91-year-old woman with severe aortic stenosis successfully underwent maintenance hemodialysis via arteriovenous fistula after transcatheter aortic valve implantation: a case report with literature review

A vesetranszplantáció korai posztoperatív hatásai a szív- és érrendszeri betegségekre klinikai gyakorlatunkban

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