Risk Factors and Midterm Prognosis of Acute Kidney Injury Following Transapical Aortic Valve Replacement

Haldenwang, PL; Rehman, Aamer; Schlömicher, Markus; Useini, Dritan; Strauch, Justus

doi:10.1055/s-0037-1598950

Cited by 2 publications

(3 citation statements)

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“…In our analysis of midterm mortality, the protectiveness of mini-SAVR persisted at follow-up. This result is consistent with the findings of several studies, 8,19–21 including Hirji et al, 20 which reported preference of mini-SAVR (performed via hemisternotomy) over TAVR in patients older than 80 years, with a long-term survival rate of approximately 92% at 10-year follow-up.…”

Section: Discussionsupporting

confidence: 92%

“…4). 8,10,12,13,[16][17][18][19][20][21][22][23] Five reports exclusively used ministernotomy as their minimally invasive surgical approach, 2 exclusively used minithoracotomy, 1 exclusively used sutureless SAVR valves, and the remaining reports used a mixture of mini-SAVR approaches. With regard to TAVR technique, transfemoral access was the most utilized approach, followed by transapical.…”

Section: Search Resultsmentioning

confidence: 99%

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Minimally Invasive Versus Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis and Systematic Review

Ahmed,

Awad,

Varghese

et al. 2023

Innovations�(Phila)

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Objective: Transcatheter aortic valve replacement (TAVR) has arisen as a viable alternative to surgery. Similarly, minimally invasive surgical aortic valve replacement (mini-SAVR), such as ministernotomy and minithoracotomy, have also gained interest. We conducted a pairwise meta-analysis to further investigate the efficacy of TAVR versus mini-SAVR. Methods: Medical databases were comprehensively searched for studies comparing TAVR with a mini-SAVR modality, defined as minimally invasive aortic surgery, ministernotomy, minithoracotomy, or rapid-deployment or sutureless SAVR. Random-effects meta-analysis was conducted using the generic inverse variance method. Primary outcomes included 30-day mortality, midterm mortality, 30-day stroke, acute kidney injury (AKI), paravalvular leak (PVL), new permanent pacemaker (PPM), new-onset atrial fibrillation, and postintervention mean and peak valve pressure gradients and were pooled as risk ratio (RR), mean difference (MD), or hazard ratio (HR) with 95% confidence interval (CI). Results: A total of 5,071 patients (2,505 mini-SAVR vs 2,566 TAVR) from 12 studies were pooled. Compared with TAVR, mini-SAVR showed significantly lower rates of both 30-day (RR = 0.63, 95% CI: 0.42 to 0.96, P = 0.03) and midterm mortality at 4 years of follow-up (HR = 0.76, 95% CI: 0.67 to 0.87, P < 0.001). Furthermore, mini-SAVR was protective against 30-day PVL (RR = 0.07, 95% CI: 0.04 to 0.13, P < 0.001) and new PPM (RR = 0.25, 95% CI: 0.11 to 0.57, P < 0.001). Conversely, TAVR was protective against 30-day AKI (RR = 1.67, 95% CI: 1.20 to 2.32, P = 0.002) and postinterventional mean gradients (MD = 1.65, 95% CI: 0.25 to 3.05, P = 0.02). No difference was observed for 30-day stroke (RR = 0.84, 95% CI: 0.56 to 1.24, P = 0.38), new-onset atrial fibrillation (RR = 1.79, 95% CI: 0.93 to 3.44, P = 0.08), or postinterventional peak gradients (MD = 3.24, 95% CI: −1.10 to 7.59, P = 0.14). Conclusions: Compared with TAVR, mini-SAVR was protective against 30-day and midterm mortality, 30-day PVL, and new permanent pacemaker, while TAVR patients had lower 30-day AKI. Future randomized trials comparing the efficacy of mini-SAVR approaches with TAVR are needed.

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Section: Discussionsupporting

confidence: 92%

Section: Search Resultsmentioning

confidence: 99%

Minimally Invasive Versus Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis and Systematic Review

Ahmed,

Awad,

Varghese

et al. 2023

Innovations�(Phila)

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“…21 Additionally, MINIAVR has been found to carry a lower risk of acute kidney injury compared to TAVI, further highlighting its potential to provide better outcomes and safeguard renal function in patients with renal dysfunction undergoing aortic valve procedures. 22 While TAVI is an effective and minimally invasive procedure for treating aortic stenosis in selected patients, it should be approached with caution when considering severe pure AR due to certain concerns. In a particular study involving 43 patients with severe AR where TAVI was attempted, the overall success rate was 74.4%; of note, 18% of cases required a second valve during the index procedure.…”

Section: Rationale For Miniavrmentioning

confidence: 99%

El potencial de MINIAVR: un enfoque innovador en pacientes con afecciones complejas

de la Cerda-Belmont,

Garza-de la Maza,

Cepeda-Flores

et al. 2024

Cirugía Cardiaca en México

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Ankylosing spondylitis is a chronic, inflammatory disease that rarely involves the heart, often causing aortic valve regurgitation with aortitis. Transcatheter aortic valve implantation has been explored as a treatment option, but it may not be suitable for all cases. Minimal invasive cardiac surgery highlights its potential benefits for patients with limited respiratory and renal function and chest wall deformities, emphasizing the importance of individualized assessment for innovative approaches in complex conditions.

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Risk Factors and Midterm Prognosis of Acute Kidney Injury Following Transapical Aortic Valve Replacement

Cited by 2 publications

References 0 publications

Minimally Invasive Versus Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis and Systematic Review

Minimally Invasive Versus Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis and Systematic Review

El potencial de MINIAVR: un enfoque innovador en pacientes con afecciones complejas

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