Abstract 13191: Acute Renal Injury and Mortality After Transcatheter Aortic Valve Replacement

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Rafael A Meneguz-Moreno ◽  
Antonio D Castro-Filho ◽  
Tannas Jatene ◽  
Guilherme Barreto G Silva ◽  
Mário Barbosa G Nunes ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Renal Injury ◽  
Transcatheter Aortic Valve Replacement ◽  
Independent Predictor ◽  
Acute Renal Injury ◽  
Transcatheter Aortic Valve

Introduction: The presence of acute renal injury (AKI) enhances morbimortality after surgical aortic valve. Hypothesis: This prospective observational study aims to determine the incidence of AKI after transcatheter aortic valve replacement (TAVR), its predictors and impact on 30-days and 1-year mortality. Methods: We assessed data from 224 consecutive patients with severe symptomatic aortic stenosis submitted to TAVR between January 2009 and February 2015 on two tertiary cardiologic centers, conducted by the same heart team. All patients used an ionic, low-osmolar, low-viscosity contrast. Kidney injury was defined according to VARC criteria, following AKIN system, and data collected until the seventh day post-procedure. Three patients were excluded due to death during the procedure, considering those deaths not related to renal dysfunction, remaining 221 patients analysed separated in two groups: AKI group and non-AKI group. Follow-up was performed on 30 days and after one year. Results: Fifty two patients (23.5%) developed AKI until seventh day of procedure. Groups 1 and 2 were similar, except for EuroSCORE II (8.66% ± 5.64% vs 7.34% ± 8.58%, p = 0.02) and glomerular filtration rate (GFR) (39.59 ml/min.1.73m2 ± 13.62 vs. 48.49 ± 19.6, p = 0.002). Overall 30 days-mortality and 1-year mortality was 6.3% and 14.0%, respectively. Both 30-day mortality (23.1% vs 1.2%, p < 0.001) and 1-year mortality (44.2% vs 4.7%, p< 0.001) were higher in group 1. In multivariable-adjusted models, the only independent predictor for AKI after TAVR was baseline GFR [hazard ratio (HR) 1.37, CI 95% 1.08-1.77, p = 0.01]. Regarding long term follow-up, AKI (HR 19.86, CI 95% 7.31-53.98, p <0.001) and COPD (HR 3.14, CI 95% 1.05-9.40, p = 0.04) were independent risk factors for 1-year mortality, whilst hypertension (HR 0.269, CI 95% 0.09-0.80, p = 0.01) was shown to be protective for long term mortality. Conclusion: In this TAVR sample, baseline GFR was the only independent predictor of AKI, and patients who developed it had significantly higher mortality at 30 days and 1 year. Acute renal impairment was the strongest risk factor for mortality and adverse cardiovascular events that provided risk information beyond the traditional scores, as EuroSCORE II and STS.

Abstract 15741: Long Term Survival Following Transcatheter Aortic Valve Replacement: Results From a Single US High Volume Center

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ricardo O Escarcega ◽  
Rebecca Torguson ◽  
Marco A Magalhaes ◽  
Nevin C Baker ◽  
Sa’ar Minha ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Term Survival ◽  
Transcatheter Aortic Valve ◽  
Significant Difference ◽  
Long Term Mortality

Introduction: Mortality following Transcatheter aortic valve replacement (TAVR) has been reported up to 5 years. However, mortality after 5 years remains unclear. Hypothesis: We aim to determine the mortality in patients undergoing TAVR >5 years follow up. Methods: From our institution’s prospectively collected TAVR database we analyzed all patients undergoing TAVR to a maximum follow up of 8 years. We divided our population into transapical TAVR (TA-TAVR) and transfemoral TAVR (TF-TAVR) groups. A Kaplan-Meier survival analysis was conducted. Results: A total of 511 patients who underwent TAVR were included in the analysis. Patients undergoing TA-TAVR had higher rates of peripheral vascular disease compared with TF-TAVR (56% vs 29%, p<0.001) and Society of Thoracic Surgeons Score (10.9 ± 4 vs 9.2 ± 4, p<0.001). TA-TAVR was associated with higher mortality at 1 year (32% vs 21%, p=0.01). However, there was no significant difference in very-long term mortality of patients undergoing TA-TAVR vs TF-TAVR (Figure). Conclusions: Long-term mortality following TAVR surpasses 50%. While in the first 2 years TA-TAVR is associated with higher mortality rates after three years the survival rates are similar in both approaches.

scholarly journals TCT-624 Acute Renal Injury and Mortality After Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 66 (15) ◽  
pp. B255
Author(s):  
Rafael A. Meneguz-Moreno ◽  
Antonio d Castro Filho ◽  
Tannas Jatene ◽  
Mario B. Nunes ◽  
Guilherme Barreto G Silva ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Renal Injury ◽  
Transcatheter Aortic Valve Replacement ◽  
Acute Renal Injury ◽  
Transcatheter Aortic Valve

scholarly journals Long-term follow-up after transcatheter aortic valve replacement

CJC Open ◽  
2021 ◽  
Author(s):  
Stephan Haussig ◽  
Constantin Pleissner ◽  
Norman Mangner ◽  
Felix Woitek ◽  
Marion Zimmer ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Long Term Follow Up

Causes and timing of death during long-term follow-up after transcatheter aortic valve replacement

2014 ◽  
Vol 168 (5) ◽  
pp. 798-806 ◽  
Author(s):  
Francesco Saia ◽  
Azeem Latib ◽  
Cristina Ciuca ◽  
Valeria Gasparetto ◽  
Massimo Napodano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Long Term Follow Up ◽  
Timing Of Death

Association of aortic valvular complex calcification burden with procedural and long-term clinical outcomes after transcatheter aortic valve replacement

2021 ◽  
Author(s):  
Euihong Ko ◽  
Do-Yoon Kang ◽  
Jung-Min Ahn ◽  
Tae Oh Kim ◽  
Ju Hyeon Kim ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Clinical Outcomes ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
High Tertile ◽  
Transcatheter Aortic Valve ◽  
All Cause Mortality ◽  
Composite Outcomes

Abstract Aims This study aimed to assess the impact of valvular/subvalvular calcium burden on procedural and long-term outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Methods and results In this prospective observational cohort study, we included patients with AS undergoing TAVR between March 2010 and December 2019. Calcium burden at baseline was quantified using multidetector computed tomography and the patients were classified into tertile groups according to the amount of calcium. Procedural outcomes [paravalvular leakage (PVL) or permanent pacemaker insertion (PPI)] and 12-month clinical outcomes (composite of death, stroke, or rehospitalization, and all-cause mortality) were assessed. A total of 676 patients (age, 79.8 ± 5.4 years) were analysed. The 30-day rates of moderate or severe PVL (P-for-trend = 0.03) and PPI (P-for-trend = 0.002) proportionally increased with the tertile levels of calcium volume. The 12-month rate of primary composite outcomes was 34.2% in low-tertile, 23.9% in middle-tertile, and 25.8% in high-tertile groups (log-rank P = 0.02). After multivariable adjustment, the risk for primary composite outcomes at 12 months was not significantly different between the tertile groups of calcium volume [reference = low-tertile; middle-tertile, hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.54–1.22; P = 0.31; high-tertile, HR 0.93; 95% CI 0.56–1.57; P = 0.80]. A similar pattern was observed for all-cause mortality. Conclusion The rates of PVL and PPI proportionally increased according to the levels of valvular/subvalvular calcium volume, while the adjusted risks for composite outcomes and mortality at 12 months were not significantly different.

The JenaValve pericardial transcatheter aortic valve replacement system to treat aortic valve disease

2021 ◽  
Author(s):  
Thomas Poschner ◽  
Paul Werner ◽  
Alfred Kocher ◽  
Guenther Laufer ◽  
Francesco Musumeci ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Pacemaker Implantation ◽  
Limited Data ◽  
Transcatheter Aortic Valve ◽  
Paper Clip ◽  
Replacement System

Transcatheter aortic valve replacement is a valuable alternative technique to surgery and the spectrum of therapy continues to evolve. The JenaValve Pericaridal transcatheter aortic valve replacement System allows prosthesis fixation in a native, noncalcified aortic annulus with a unique paper clip-like anchorage mechanism. The low rate of paravalvular leakage and permanent pacemaker implantation emphasizes the further widespread use of the JenaValve – despite the limited data available. In May 2021, a CE mark for the transfemoral implantation in both aortic regurgitation and aortic stenosis was granted. However, no data have been published so far. The ongoing ALIGN trials are expected to provide the pending long-term data.

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