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Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Implantation Balloon Aortic Valvuloplasty as a Bridge to Aortic Valve Replacement: A Contemporary Nationwide Perspective Decline in Left Ventricular Ejection Fraction During Follow-Up in Patients With Severe Aortic Stenosis Randomized Evaluation of TriGuard 3 Cerebral Embolic Protection After Transcatheter Aortic Valve Replacement: REFLECT II Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement Rationale and design of a randomized clinical trial comparing safety and efficacy of Myval transcatheter heart valve versus contemporary transcatheter heart valves in patients with severe symptomatic aortic valve stenosis: the LANDMARK trial Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Comparison of Early Surgical or Transcatheter Aortic Valve Replacement Versus Conservative Management in Low-Flow, Low-Gradient Aortic Stenosis Using Inverse Probability of Treatment Weighting: Results From the TOPAS Prospective Observational Cohort Study 2020 ACC Expert Consensus Decision Pathway on Management of Conduction Disturbances in Patients Undergoing Transcatheter Aortic Valve Replacement A Report of the American College of Cardiology Solution Set Oversight Committee Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement Is Not Associated With Increased Early or Late Readmission Risk
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Original Research2021 Jan 14;S0002-8703(21)00011-9.

JOURNAL：Am Heart J. Article Link

Late kidney injury after transcatheter aortic valve replacement

Y Adachi, M Yamamoto, OCEAN-TAVI investigators et al. Keywords: late kidney injury; TAVR; clinical outcome

ABSTRACT

BACKGROUND - Information on early to late-phase kidney damage in patients who underwent transcatheter aortic valve replacement (TAVR) is scarce. We aimed to identify the predictive factors for late kidney injury (LKI) at 1-year and patient prognosis beyond 1-year after TAVR.

 

METHODS - We retrospectively reviewed 1705 patients’ data from the Japanese TAVR multicenter registry. Acute kidney injury (AKI) and LKI, defined as an increase of at least 0.3 mg/dl in creatinine level, a relative 50% decrease in kidney function from baseline to 48-hours and 1-year, were evaluated. The patients were categorized into the four groups as AKI- /LKI- (n=1362), AKI+ /LKI- (n=95), AKI- /LKI+ (n=199), and AKI+ /LKI+ (n=46).

 

RESULTS - The cumulative 3-year mortality rates were significantly increased across the four groups (12.5%, 15.8%, 24.6%, 25.8%, p<0.001). Multivariate analysis revealed that chronic kidney disease, coronary artery disease, peri-procedural AKI, and heart failure-related re-admission within 1-year were significantly associated with LKI. The Cox regression analysis revealed that AKI- /LKI+ and AKI+ /LKI+ were independent predictors of increased late mortality beyond 1-year after TAVR (p=0.001 and p=0.01).

 

CONCLUSION - LKI was influenced by adverse cardio-renal events and was associated with increased risks of late mortality beyond 1-year after TAVR.

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