Impact of varying degrees of renal dysfunction on transcatheter and surgical aortic valve replacement

Nguyen, Tom C.; Babaliaros, Vasilis; Razavi, Seyed Amirhossein; Kilgo, Patrick D.; Guyton, Robert A.; Devireddy, Chandan; Shults, Christian; Mavromatis, Kreton; Kanitkar, Mihir; Block, Peter C.; Lerakis, S; Thourani, Vinod H.

doi:10.1016/j.jtcvs.2013.07.065

Cited by 76 publications

(61 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[10][11][12][13][17][18][19][20][21] The characteristics of the included studies are reported in Table 1. There was no significant variability in the CKD definitions used across the studies.…”

Section: Resultsmentioning

confidence: 99%

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Gargiulo

Capodanno

Sannino

et al. 2015

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

T ranscatheter aortic valve implantation (TAVI) has emerged as an alternative to surgery therapy for severe aortic stenosis.1,2 The detrimental impact of baseline chronic kidney disease (CKD) on worsening the prognosis of patients undergoing surgical aortic valve replacement is well established. 3,4 Conversely, this remains a debated issue in patients undergoing TAVI.Mixed evidences are available regarding the relationship between baseline CKD and clinical outcomes in TAVI, and patients with CKD were typically under-represented in TAVI trials. On the other hand, CKD showed to be an independent predictor of mortality at 1-year after TAVI in some registries, [5][6][7][8] but not in others. 9 The degree of CKD, which exposes to the highest risk is also a matter of debate: recent data suggest that CKD stage 4 and 5, but not stage 3, are predictors of 30-day and late mortality after TAVI.10,11 Finally, cross-sectional studies failed to show a significant impact of CKD on mortality. 12,13 On this background, given the contrasting evidence and the latest literature in this field, there is a clinical and scientific rationale to investigate the impact of preoperative CKD on the clinical outcomes of patients undergoing TAVI. Methods Study SelectionThe study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses requirements. MEDLINE, Cochrane, ISI Web of Science, and SCOPUS databases were searched Background-There is a conflicting evidence on safety and efficacy of transcatheter aortic valve implantation in patients with preoperative chronic kidney disease (CKD). Therefore, we conducted a meta-analysis on the impact of CKD on outcomes after transcatheter aortic valve implantation. Methods and Results-Nine

show abstract

Section: Resultsmentioning

confidence: 99%

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Gargiulo

Capodanno

Sannino

et al. 2015

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

show abstract

“…TAVR has been shown to be at least as safe and effective as SAVR in patients with CKD and CLD. [15][16][17][18] However, patients with CKD and CLD undergoing TAVR are at increased risk of procedural complications, mortality, and rehospitalization when compared with those without these conditions. 17,18 In addition to patient comorbidities, TA-TAVR and AKI were also identified as independent predictors of 30-day readmission.…”

Section: Discussionmentioning

confidence: 99%

Thirty-Day Readmissions After Transcatheter Aortic Valve Replacement in the United States

Kolte

Khera

Sardar

et al. 2017

Circ: Cardiovascular Interventions

140

View full text Add to dashboard Cite

T hirty-day readmission rates are considered a quality performance measure. The Centers for Medicare and Medicaid Services publicly reports 30-day readmission rates for cardiovascular diagnoses and procedures such as acute myocardial infarction, heart failure, percutaneous coronary intervention (PCI; as a pilot project between 2013 and 2014), and coronary artery bypass grafting. , bleeding (7.6%), and peripheral vascular disease (4.3%) were the most common noncardiac causes, whereas heart failure (22.5%) and arrhythmias (6.6%) were the most common cardiac causes of readmission. Median length of stay and cost of readmissions were 4 days (interquartile range, 2-7 days) and $8302 (interquartile range, $5229-16 021), respectively. Conclusions-Thirty-day readmissions after TAVR are frequent and are related to baseline comorbidities, TAVR access site, and post-procedure complications. Awareness of these predictors can help identify and target high-risk patients for interventions to reduce readmissions and costs. Key Words: aortic stenosis ◼ costs and cost analysis ◼ length of stay ◼ readmission ◼ rehospitalization ◼ transcatheter aortic valve implantation ◼ transcatheter aortic valve replacement

show abstract

“…Data on renal function before SAVR are extensive but have been examined in less detail, with some studies showing decreased survival with advanced CKD9 17 and others suggesting renal function has little effect on mortality 7 18. However, a recent systematic review has highlighted that both in-hospital and longer term mortality is very high among dialysis patients undergoing any type of surgical valve replacement 19.…”

Section: Discussionmentioning

confidence: 99%

“…Large scale outcome data examining the impact of CKD on outcomes after TAVI are still lacking and studies to date have been inconsistent. While some studies have found a relationship between renal dysfunction and worse outcomes,8 others have not 9 10. A recent study demonstrated that although advanced CKD was an independent risk factor for mortality, earlier stage disease was not.…”

Section: Introductionmentioning

confidence: 99%

Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): an analysis of the UK TAVI registry

Ferro

Chue

Belder

et al. 2015

Heart

View full text Add to dashboard Cite

show abstract

Impact of varying degrees of renal dysfunction on transcatheter and surgical aortic valve replacement

Cited by 76 publications

References 18 publications

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Thirty-Day Readmissions After Transcatheter Aortic Valve Replacement in the United States

Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): an analysis of the UK TAVI registry

Contact Info

Product

Resources

About