The ratio of contrast volume to glomerular filtration rate predicts acute kidney injury and mortality after transcatheter aortic valve implantation

2017 ◽  
Vol 18 (5) ◽  
pp. 349-355 ◽  
Author(s):  
Francesco Giannini ◽  
Azeem Latib ◽  
Richard J. Jabbour ◽  
Massimo Slavich ◽  
Susanna Benincasa ◽  
...  
2019 ◽  
Author(s):  
Daisuke Miura ◽  
Yasutaka Yamada ◽  
Shinichiro Kusaba ◽  
Eijiro Nogami ◽  
Junji Yunoki ◽  
...  

Abstract Objective: This study aimed to determine if contrast medium volume (CMV) is a risk factor for acute kidney injury (AKI) during transcatheter aortic valve implantation (TAVI) via a transfemoral approach performed without major complications. All TAVI procedures performed at our institution between March 2014 and March 2018 were retrospectively reviewed. AKI was diagnosed using the Acute Kidney Injury Network classification based on the Valve Academic Research Consortium-2 definition. Procedures performed via a transapical approach and those in which circulatory dynamics failed intraoperatively were excluded. Results: Eighty-one (96.4%) of 100 patients scheduled for TAVI were enrolled; seven (8.6%) developed AKI and 74 (91.4%) did not. The serum creatinine (SCr) level was significantly higher (p<0.05) and the estimated glomerular filtration rate was significantly lower in the AKI group (p<0.05). The CMV was significantly higher in the AKI group (103ml vs 84ml, p<0.05), as was the CMV × SCr/BW value (3.34 vs 1.49, p<0.01). The area under the curve for CMV × SCr/BW was 0.9228 and the cutoff value was 2.99. The CMV, SCr, and estimated glomerular filtration rate affect the likelihood of AKI after transfemoral TAVI and a CMV × SCr/BW value > 2.99 accurately predicts AKI.


2019 ◽  
Author(s):  
Daisuke Miura ◽  
Yasutaka Yamada ◽  
Shinichiro Kusaba ◽  
Eijiro Nogami ◽  
Junji Yunoki ◽  
...  

Abstract Objective: This study aimed to determine if contrast medium volume (CMV) is a risk factor for acute kidney injury (AKI) during transcatheter aortic valve implantation (TAVI) via a transfemoral approach performed without major complications. All TAVI procedures performed at our institution between March 2014 and March 2018 were retrospectively reviewed. AKI was diagnosed using the Acute Kidney Injury Network classification based on the Valve Academic Research Consortium-2 definition. Procedures performed via a transapical approach and those in which circulatory dynamics failed intraoperatively were excluded. Results: Eighty-one (96.4%) of 100 patients scheduled for TAVI were enrolled; seven (8.6%) developed AKI and 74 (91.4%) did not. The serum creatinine (SCr) level was significantly higher (p<0.05) and the estimated glomerular filtration rate was significantly lower in the AKI group (p<0.05). The CMV was significantly higher in the AKI group (103ml vs 84ml, p<0.05), as was the CMV × SCr/BW value (3.34 vs 1.49, p<0.01). The area under the curve for CMV × SCr/BW was 0.9228 and the cutoff value was 2.99. The CMV, SCr, and estimated glomerular filtration rate affect the likelihood of AKI after transfemoral TAVI and a CMV × SCr/BW value > 2.99 accurately predicts AKI.


2014 ◽  
Vol 5 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Ilker Gul ◽  
Mustafa Zungur ◽  
Ahmet Tastan ◽  
Faik Fevzi Okur ◽  
Ertan Damar ◽  
...  

Background/Aim: Transcatheter aortic valve implantation (TAVI) is a method which is increasingly applied in severe aortic stenosis treatment. The development of contrast-induced nephropathy (CIN) after TAVI increases morbidity and mortality rates. Within the scope of this study, the importance of the contrast medium volume to glomerular filtration rate (CV/GFR) ratio in determining the development of CIN and the amount of CV that could be applied was evaluated. Methods: Seventy-two patients (aged 78.6 ± 11.6 years; 38 females) who underwent aortic valve replacement with the TAVI method between June 2013 and August 2014 were included in the study. CIN was defined as an absolute increase in serum creatinine of >0.5 mg/dl or a relative increase of >25% within 48-72 h after TAVI. CIN+ and CIN- patients were classified into two groups. The χ2 test, t test, Mann-Whitney U test, ROC analysis, and univariate and multivariate regression analyses were applied for statistical analyses. Results: CIN was detected in 16 patients (22%) in our study. Baseline creatinine, baseline GFR, the Mehran risk score, CV, and the CV/GFR ratio were determined as the predictive factors of CIN development. A CV/GFR ratio of 3.9 was specified to predict CIN development with 71% sensitivity and 80% specificity. Conclusion: After TAVI, CIN may develop due to various reasons. In patients to whom TAVI was applied, the CV/GFR ratio may be a guideline helping to prevent the development of renal pathologies. The amount of contrast medium that can be given to a patient can be calculated in terms of baseline GFR.


2014 ◽  
Vol 107 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Yacine Elhmidi ◽  
Sabine Bleiziffer ◽  
Marcus-André Deutsch ◽  
Markus Krane ◽  
Domenico Mazzitelli ◽  
...  

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