Renal protection of transaxillary/subclavian accesses for transcatheter aortic valve implantation in patients with impossible femoral access.
Rui ShiQinghen WuHong-Tao TiePublished in: Scandinavian cardiovascular journal : SCJ (2021)
Acute kidney injury (AKI) is a common postoperative complication after transcatheter aortic valve replacement (TAVR). In patients with ineligible femoral access, transaxillary/subclavian (TAx/TSc) might be competitive alternative access. With nine cohort studies and 4995 patients, we found that TAx/TSc access was associated with decreased incidences of AKI (Relative risk [RR]: 0.573, 95% confidence interval [CI]:0.456-0.718, p < .001) and stage 3 AKI (RR 0.460, 95%CI 0.318-0.665, p < .001) by comparison with intrathoracic approaches. Our findings suggest that TAx/TSc is associated with a reduced AKI risk after TAVR in patients with impossible femoral access.
Keyphrases
- acute kidney injury
- transcatheter aortic valve replacement
- aortic stenosis
- aortic valve
- transcatheter aortic valve implantation
- ejection fraction
- aortic valve replacement
- cardiac surgery
- end stage renal disease
- chronic kidney disease
- newly diagnosed
- prognostic factors
- patients undergoing
- coronary artery disease
- heart failure
- left ventricular
- patient reported outcomes