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Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial Valve‐in‐Valve for Degenerated Transcatheter Aortic Valve Replacement Versus Valve‐in‐Valve for Degenerated Surgical Aortic Bioprostheses: A 3‐Center Comparison of Hemodynamic and 1‐Year Outcome Anticoagulation After Surgical or Transcatheter Bioprosthetic Aortic Valve Replacement Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios Left Ventricular Hypertrophy and Clinical Outcomes Over 5 Years After TAVR: An Analysis of the PARTNER Trials and Registries Long-term outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement Long-Term Outcomes of Anticoagulation for Bioprosthetic Valve Thrombosis Clinical impact of conduction disturbances in transcatheter aortic valve replacement recipients: a systematic review and meta-analysis Decline in Left Ventricular Ejection Fraction During Follow-Up in Patients With Severe Aortic Stenosis
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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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