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Acute Kidney Injury Following Transcatheter Aortic Valve Implantation: Incidence, Predictive Factors And Prognostic effects
Aiman Alassar, Nada Abdulkareem, Oswaldo Valencia, Stephen Brecker, Marjan Jahangiri.
St George's Hospital, London, United Kingdom.
OBJECTIVE:
Acute Kidney injury (AKI) is a common complication following surgical aortic valve replacement and is associated with increased mortality. Little is known about the occurrence of AKI after transcatheter aortic valve implantation (TAVI). The aim of the study was to establish the incidence predictive factors and prognostic value of AKI following TAVI.
METHODS:
Between January 2008 and January 2011, a total of 81 patients with severe aortic stenosis (AS) who underwent TAVI with the Medtronic CoreValve System or Edwards SAPIEN heart valve were included. Baseline characteristics and procedural complications were recorded. AKI was defined as an increase in creatinine levels more than 26.4 mol/L or more than 50% from baseline or more than 1.5 fold from baseline occurring within 48 hours.
RESULTS:
Postoperatively, 10 patients (12.3%) developed acute kidney injury which was completely resolved in 9 prior to hospital discharge. Predictive factors of acute kidney injury were diabetes (OR 6.722) and pre-renal dysfunction (OR 1.024). 11 patients (13.5%) died within one year following TAVI. 3 of the nonsurvivors (3.7%) had developed AKI postoperatively. AKI was not a predictive factor of one year mortality following TAVI.
CONCLUSIONS:
Acute Kidney Injury occurred in 12.3% of the patients following TAVI and persisted in only one patient prior to hospital discharge. Diabetes and pre-renal dysfunction were found to be the main predictive factors of AKI after TAVI. AKI was not associated with increased one year mortality
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