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The effects of VARC-defined acute kidney injury after transcatheter aortic valve implantation (TAVI) using the Edwards bioprosthesis.

AbstractAIMS:
The aim of this study was to identify the incidence and risk factors for acute kidney injury (AKI) after TAVI, a potentially serious complication of transcatheter aortic valve implantation (TAVI) that has been redefined by the Valve Academic Research Consortium (VARC).
METHODS AND RESULTS:
We performed a retrospective analysis of 248 patients undergoing TAVI. AKI was defined as a VARC-modified Risk, Injury, Failure, Loss, and End-stage (RIFLE) kidney disease score ≥ 2. Eighty-nine patients suffered AKI (35.9%) and demonstrated increased mortality at 30 days (13.5% vs. 3.8%) and one year (31.5% vs. 15.0%) (p<0.001). Multivariate regression analysis identified diabetes mellitus (p<0.001), peripheral vascular disease (p=0.007), chronic kidney disease stage (p=0.010) as independently associated risk factors for AKI.
CONCLUSIONS:
More than one third of patients sustain AKI after TAVI using the Edwards bioprosthesis, as defined by the VARC-modified RIFLE score. AKI increased the mortality at both 30 days and at one year. A history of diabetes mellitus, peripheral vascular disease and higher chronic kidney disease stage had the strongest independent associations with post-TAVI AKI.
AuthorsMuhammed Zeeshan Khawaja, Martyn Thomas, Abhishek Joshi, Kaleab N Asrress, Karen Wilson, Kirsty Bolter, Christopher P Young, Jane Hancock, Vinayak Bapat, Simon Redwood
JournalEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (EuroIntervention) Vol. 8 Issue 5 Pg. 563-70 (Sep 2012) ISSN: 1969-6213 [Electronic] France
PMID22995082 (Publication Type: Journal Article)
Topics
  • Acute Kidney Injury (epidemiology, etiology, mortality)
  • Aged
  • Aged, 80 and over
  • Aortic Valve (surgery)
  • Bioprosthesis
  • Cardiac Catheterization
  • Female
  • Heart Valve Prosthesis Implantation (adverse effects)
  • Humans
  • Logistic Models
  • Male
  • Retrospective Studies
  • Risk Factors

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