Impact of Transcatheter Aortic Valve Implantation on Kidney Function: the “Renovalvular” Interaction in Aortic Stenosis

Abstract Background: Chronic kidney disease (CKD) is frequently present in patients with aortic valve disease. Decreased kidney perfusion as a consequence of reduced cardiac output may contribute to renal dysfunction in this setting. Objective: Given the potential reversibility of kidney hypoperfusion after valve repair, this study aimed to analyze the impact of percutaneous transcatheter aortic valve implantation (TAVI) on kidney function. Methods: We performed a retrospective analysis of 233 consecutive patients who underwent TAVI in a single center between November 2008 and May 2016. We assessed three groups according to their baseline estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2): Group 1 with eGFR ≥ 60; Group 2 with 30 ≤ eGFR
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research

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Publication date: November 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 6Author(s): Vincent M. Brandenburg, Alexander Schuh, Rafael KramannAccelerated and premature cardiovascular calcification is a hallmark of patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD). The presence and the amount of cardiovascular calcification are among the driving forces of increased morbidity and mortality in renal patients. Cardiovascular calcification occurs at different sites, including the cardiac valves—a location that is of particular importance for both the patient and the treating phy...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
We examined patients with chronic kidney disease and severe aortic stenosis undergoing SAVR or TAVR procedure between 2007-2017; excluding age90, dialysis, endocarditis, non-aortic valve stenosis, or patients died within 48-hours post-procedure.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Acute kidney recovery (AKR) is a recently described phenomenon observed after transcatheter aortic valve replacement (TAVR) and is more frequent than acute kidney injury (AKI). To determine the incidence and predictors of AKR between surgical aortic valve replacement (SAVR) and TAVR, we examined patients with chronic kidney disease and severe aortic stenosis who underwent SAVR or TAVR procedure between 2007 and 2017; excluding age90, dialysis, endocarditis, non-aortic valve stenosis, or patients died within 48-hours postprocedure.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Chronic kidney disease (CKD) is a major risk factor for valvular heart disease (VHD). Mitral annular and aortic valve calcifications are highly prevalent in CKD patients and commonly lead to valvular stenosis and regurgitation, as well as complications including conduction system abnormalities and endocarditis. VHD, especially mitral regurgitation and aortic stenosis, is associated with significantly reduced survival among CKD patients. Knowledge related to VHD in the general population is not always applicable to CKD patients because the pathophysiology may be different, and CKD patients have a high prevalence of comorbid...
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: KDIGO Executive Conclusions Source Type: research
Publication date: September 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 9Author(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 2 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 ne...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
AbstractThe reliability of fractional flow reserve (FFR) in aortic stenosis (AS) has been questioned because of the uncertain response to vasodilators. A retrospective multicenter cohort of 114 AS patients who underwent coronary physiology assessment was compared with 154 controls before and after propensity matching adjustment. The difference between resting distal coronary vs aortic pressure ratio (Pd/Pa) and FFR ( ΔPd/Pa-FFR) was tested against the severity of AS. ΔPd/Pa-FFR was not influenced by the severity of AS in terms of aortic valve area (r = − 0.02,p = 0.83) a...
Source: Journal of Cardiovascular Translational Research - Category: Cardiology Source Type: research
CONCLUSION: Regional patients treated with transcatheter aortic valve implantation for severe aortic stenosis have non-inferior 30-day and 12-month outcomes, when compared with urban patients. Frailty is a predictor of poor functional improvement post-transcatheter aortic valve implantation. PMID: 31074928 [PubMed - as supplied by publisher]
Source: The Australian Journal of Rural Health - Category: Rural Health Authors: Tags: Aust J Rural Health Source Type: research
CONCLUSION: Aortic valve replacement, whether by surgical aortic valve replacement or transcatheter aortic valve implantation, improved estimated glomerular filtration rate at 1 year in more than half of patients with chronic kidney disease stage 3b-5. PMID: 30655226 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - Category: Cardiology Authors: Tags: Arch Cardiovasc Dis Source Type: research
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 ne...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
We examined 717 patients with severe AS and HF undergoing TAVI. NT-proBNP nonresponders were defined as patients whose NT-proBNP levels decreased by  ≤ 30%. Mean NT-proBNP levels decreased from 7698 ± 7853 pg/mL (baseline) to 4523 ±  5173 pg/mL (post-TAVI); 269 patients (38%) were nonresponders. Female gender and prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), atrial fibrillation (AF), and history of coronary artery revascularization were more common for NT-proBNP nonresponders. Permanent pacemaker implantation rate was higher for N...
Source: Heart and Vessels - Category: Cardiology Source Type: research
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