Factors associated with acute kidney injury in patients undergoing transcatheter aortic valve implantation: Short-term outcomes and impact of right heart failure.

Northern clinics of Istanbul Pub Date : 2024-04-24 eCollection Date: 2024-01-01 DOI:10.14744/nci.2024.87864
Dilek Aslan Kutsal, Sait Terzi
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Abstract

Objective: Transcatheter aortic valve implantation (TAVI) was developed as an alternative to surgery for symptomatic, high-risk patients with severe aortic stenosis (AS). Acute kidney injury, a major complication of TAVI, is associated with a poor prognosis. In our study, we planned to investigate the effect of right heart failure on the development of acute kidney injury after TAVI and other factors contributing to the development of AKI.

Methods: Between January 2015 and December 2020, 198 patients who underwent TAVI due to severe symptomatic aortic stenosis at Dr. Siyami Ersek Cardiovascular Surgery Hospital were screened. Local ethics committee approval was obtained (HNEAH-KAEK 2021/134-3343). Transthoracic echocardiographic findings and laboratory evaluations were recorded. Patients were evaluated according to Acute Kidney Injury Network (AKIN) criteria.

Results: The rate of AKI after TAVI was found to be 41.9%. The mean age of patients who developed AKI was higher (80.90±6.8). AKI development rates were higher in the female gender (68.7%) and patients with hypertension (44.8%). It was observed that the risk of developing AKI was higher in patients who underwent TAVI and developed AKI afterwards, especially in patients with stage-3 and stage-4 advanced CKD before TAVI (p<0.01) We did not find an independent relationship between AKI and right-heart failure in our analysis.

Conclusion: We observed that chronic kidney disease before TAVI, advanced age, and female gender are important determinants of the development of AKI after TAVI. Although a relationship between TAVI and right heart failure has not been demonstrated, large-scale studies are needed in the future.

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经导管主动脉瓣植入术患者急性肾损伤的相关因素:短期疗效和右心衰竭的影响。
目的:经导管主动脉瓣植入术(TAVI)是为无症状、高风险的重度主动脉瓣狭窄(AS)患者提供的一种手术替代方案。急性肾损伤是 TAVI 的主要并发症,与不良预后有关。在我们的研究中,我们计划调查右心衰对TAVI术后急性肾损伤发生的影响,以及导致AKI发生的其他因素:方法:2015 年 1 月至 2020 年 12 月期间,在 Siyami Ersek 医生心血管外科医院筛查了 198 名因严重症状性主动脉瓣狭窄而接受 TAVI 的患者。该研究获得了当地伦理委员会的批准(HNEAH-KAEK 2021/134-3343)。记录了经胸超声心动图检查结果和实验室评估结果。根据急性肾损伤网络(AKIN)标准对患者进行评估:结果:TAVI术后AKI发生率为41.9%。发生 AKI 的患者平均年龄较高(80.90±6.8)。女性(68.7%)和高血压患者(44.8%)的 AKI 发生率较高。据观察,在接受 TAVI 后发生 AKI 的患者中,尤其是在 TAVI 前患有 CKD 3 期和 4 期晚期的患者中,发生 AKI 的风险更高(p 结论:我们观察到,TAVI 前的慢性肾病、高龄和女性性别是 TAVI 后发生 AKI 的重要决定因素。虽然 TAVI 与右心衰竭之间的关系尚未得到证实,但未来仍需进行大规模研究。
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