Dexmedetomidine for transcatheter aortic valve implantation. Does it protect against acute kidney injury?

Abstract

Introduction: Acute kidney injury (AKI) is a frequent complication after transcatheter aortic valve implantation (TAVI), and it presents a higher risk of myocardial infarction, severe bleeding, transfusion, dialysis, and mortality. Dexmedetomidine has a protective effect on AKI after adult cardiac surgery. We want to study the impact of dexmedetomidine on the incidence of AKI in the postoperative period of TAVI procedure in our center. Methods: We performed a retrospective cohort study comparing the administration of dexmedetomidine (DEX group) versus other sedatives (NO-DEX group) during elective TAVI procedure under transfemoral approach. Results: A total of 122 patients were included in the study. Both groups presented a similar incidence of AKI (19,8% DEX group; 19,2% NO-DEX group; p = 0,949). A subgroup analysis with patients presenting chronic kidney disease showed an AKI incidence of 24%, without statistically significant differences between both groups either. Conclusions: We did not find any difference on AKI incidence, length of hospital stay, 30-day mortality or 12-month mortality in patients undergoing TAVI procedure under sedation with dexmedetomidine compared to other sedatives in our center. It would be interesting to study this hypothetical association through studies with larger samples and better designs.