Comparison of the effect of surgical versus transcatheter aortic valve replacement on the development of postoperative acute kidney injury.
Takaomi NomiAkira KitamuraMiki TsujitaYuki ShikoYohei KawasakiHideyuki NakagawaPublished in: Heart and vessels (2023)
Acute kidney injury (AKI) frequently occurs after cardiac surgery. Recently, transcatheter aortic valve implantation (TAVI), a less invasive option for aortic stenosis (AS), has been increasingly performed, particularly in elderly patients. We retrospectively investigated and compared the incidence and risk factors of postoperative AKI in patients who underwent surgical aortic valve replacement (SAVR) and TAVI. This was a retrospective single-center study. Seven days postoperatively, data were obtained from medical records. Patients were classified into SAVR and TAVI groups based on age, according to the policy of the Japanese Circulation Society. A total of 155 patients underwent surgery for AS between January 2020 and December 2021. Variables included age, sex, risk score, preoperative left ventricular ejection fraction, hypertension, and renal dysfunction. AKI was defined in accordance with the Kidney Disease: Improving Global Outcomes criteria. A total of 33 SAVR and 79 TAVI procedures were included in this study. The incidences of AKI in the SAVR and TAVI groups were 45.5% and 43.0%, respectively. No significant differences existed between the two groups. Weight (p = 0.0392) and pre-renal dysfunction (p = 0.0308) affected the incidence of AKI in the SAVR group, whereas no such variables were identified in the TAVI group. Within the current age-based treatment selection criteria for AS, no significant difference in the incidence of AKI was observed between the two procedures.Although preoperative renal function may be associated with postoperative AKI, further studies are required to select the optimal surgical procedure for patients with renal dysfunction.
Keyphrases
- aortic stenosis
- ejection fraction
- transcatheter aortic valve implantation
- aortic valve replacement
- acute kidney injury
- transcatheter aortic valve replacement
- aortic valve
- left ventricular
- cardiac surgery
- patients undergoing
- healthcare
- end stage renal disease
- newly diagnosed
- minimally invasive
- oxidative stress
- chronic kidney disease
- physical activity
- big data
- percutaneous coronary intervention
- public health
- electronic health record
- blood pressure
- deep learning
- artificial intelligence
- body mass index
- atomic force microscopy
- single molecule
- weight gain
- skeletal muscle
- cardiac resynchronization therapy