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01-07-2021 | Aortic Valve Replacement | Original Article

Worsening renal function after transcatheter aortic valve replacement and surgical aortic valve replacement

Authors: Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Toshihiko Nishi, Yusuke Miki, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

Published in: Heart and Vessels | Issue 7/2021

Abstract

Several prior reports have investigated worsening renal function around transcatheter aortic valve replacement (TAVR) procedures. However, in clinical practice, it seems more important to evaluate changes associated with TAVR-related procedures, including preoperative enhanced computed tomography (CT), as well as the TAVR procedure itself, as CT assessment is considered essential for safe TAVR. This study evaluated worsening renal function during the TAVR perioperative period, from the preoperative enhanced CT to 1 month after TAVR, and then compared the incidence with that in patients undergoing surgical aortic valve replacement (SAVR). This retrospective single-center study investigated 123 TAVR patients and 130 SAVR patients. We evaluated baseline renal function before enhanced CT in TAVR patients and before operation in SAVR patients, and again at 1 month post-operatively. We defined worsening renal function at 1 month according to three definitions: (1) an increase in serum creatinine ≥ 0.3 mg/dL or ≥ 1.5-fold from baseline or initiation of dialysis, (2) a decline in eGFR at 1 month ≥ 20% from baseline or initiation of dialysis, (3) a decline in eGFR at 1 month ≥ 30% from baseline or initiation of dialysis. TAVR patients were significantly older and had higher surgical risk scores than SAVR patients. In TAVR patients, serum creatinine levels were 1.00 ± 0.32 mg/dL at baseline and 1.01 ± 0.40 mg/dL at 1 month post-operatively (p = 0.58), while in SAVR patients, these levels were 0.99 ± 0.51 mg/dL and 0.98 ± 0.49 mg/dL, respectively (p = 0.59). In TAVR patients, 7 (5.7%), 14 (11.4%), and 3 (2.4%) patients experienced worsening renal function according to the three definitions, respectively, but there were no significant differences from those in SAVR patients, for any definition. Worsening renal function after TAVR was uncommon, and the incidence rate was comparable to that in SAVR patients, even though TAVR patients had worse baseline characteristics.

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Title: Worsening renal function after transcatheter aortic valve replacement and surgical aortic valve replacement
Authors: Akihiro Tobe
Akihito Tanaka
Yoshiyuki Tokuda
Toshihiko Nishi
Yusuke Miki
Kenji Furusawa
Hideki Ishii
Akihiko Usui
Toyoaki Murohara
Publication date: 01-07-2021
Publisher: Springer Japan
Keywords: Aortic Valve Replacement
Computed Tomography
Computed Tomography
Aortic Valve Replacement
Aortic Valve Replacement
Published in: Heart and Vessels / Issue 7/2021
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-021-01778-2

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Springer Medicine

Worsening renal function after transcatheter aortic valve replacement and surgical aortic valve replacement

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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