Impact of chronic kidney disease on decision-making and management in transcatheter aortic valve interventions

Publication date: Available online 24 November 2018Source: Canadian Journal of CardiologyAuthor(s): Mark Hensey, Dale J. Murdoch, Janarthanan Sathananthan, David A. Wood, John G. WebbAbstractThe coexistence of chronic kidney disease (CKD) and severe aortic stenosis (AS) is common and the prevalence of both is rising. The two conditions are inherently linked in that significant CKD may accelerate the development of AS and severe AS may result in deteriorating kidney function. The volume of, and indications for transcatheter aortic valve implantation (TAVI) procedures are ever-increasing and there are many challenges that need to be considered in patients with concomitant severe AS and CKD being assessed for TAVI. Throughout the process of working these patients up for definitive management of their valvular heart disease, the presence of CKD impacts on diagnostic investigations, treatment decisions and therapeutic interventions. Herein we review current literature regarding TAVI in patients with CKD focusing on the decision-making process and specific risks involved in TAVI and CKD. We also provide specific practical strategies to best manage this challenging patient cohort.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research