Transcatheter Versus Surgical Aortic Valve Replacement in Renal Transplant Patients: A Meta-Analysis

Abstract

Background: The outcome of transcutaneous aortic valve replacement (TAVR) in patients with kidney transplant is unknown, as majority of these patients were excluded from the major TAVR clinical trials. We sought to compare patients with severe aortic stenosis who underwent TAVR versus surgical aortic valve replacement (SAVR) with a history of kidney transplant. Methods: PubMed, Google Scholar and Cochrane databases were searched to identify relevant articles. The incidence of all-cause mortality and acute kidney injury (AKI) was calculated using relative risk on a random effect model. Results: A total of 1,538 patients (TAVR 328, SAVR 1,210) were included in the study. TAVR was associated with lower mortality as compared with SAVR at 30 days from the index procedure (odds ratio (OR) 0.48, 95% confidence interval (CI): 0.25-0.93; P = 0.03). Oneyear mortality was studied in three studies and showed comparable mortality in patients undergoing TAVR and SAVR (OR: 0.76, 95% CI: 0.10-5.51; P = 0.78). Compared to SAVR, TAVR carries an identical risk of AKI (OR: 0.44, 95% CI: 0.10-1.90; P = 0.27). A sensitivity analysis performed by exclusion of Voudris et al study showed a non-significant difference in the mortality incidence of two groups at 30 days (OR: 0.72, 95% CI: 0.27-1.91; P = 0.51). Conclusions: In patients with a history of kidney transplant, TAVR was associated with a comparable risk of mortality and AKI compared to SAVR.

Single-access, non-contrast transcatheter aortic valve implantation, the ultimate minimalist approach: a case report

“… 4 Data comparing clinical outcomes between TAVI and surgical aortic valve replacement in patients with advanced renal disease are limited. 6 Mir et al . 6 reported lower mortality rates with TAVI at 30 days but a comparable rate of renal failure and 1-year death when compared with surgery.…”

“… 6 Mir et al . 6 reported lower mortality rates with TAVI at 30 days but a comparable rate of renal failure and 1-year death when compared with surgery.…”

Preoperative Cardiovascular Assessment of the Renal Transplant Recipient: A Narrative Review

“…Regarding the specific treatment of valve disorders, many guidelines exist for the treatment of valvular heart disease and reviewing these in detail would fall outside of the scope of this review [ 110 ]. There are also studies on the topic of aortic valve replacement in kidney transplant patients [ 111 , 112 ]. Both surgical and percutaneous options seem to have similar long term mortality but transcatheter aortic valve replacement (TAVR) may be associated with short initial LOS and cost of stay.…”

Left ventricular remodeling and its correlation with serum cardiac troponin I in patients with end-stage renal disease treated

“…Cardiovascular disease is the leading cause of death in ESRD dialysis patients. [5][6][7] Ventricular remodeling refers to a series of changes in the size, shape, wall thickness, and tissue structure of the ventricle due to myocardial injury or increased load. 8 It is the pathological and physiological reaction process of lesion repair, whole ventricular compensation, and secondary.…”