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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Reversibility of chronic kidney disease and outcomes following aortic valve replacement†

Marc Najjar1, Halit Yerebakan1, Robert A Sorabella1

  • 1Division of Cardiothoracic Surgery, College of Physicians and Surgeons of Columbia University-New York Presbyterian Hospital, New York, NY, USA.

Interactive Cardiovascular and Thoracic Surgery
|July 17, 2015
PubMed

Insights

Aortic valve replacement (AVR) improves kidney function in patients with chronic kidney disease (CKD). Improved kidney function after AVR is linked to better survival rates, highlighting the importance of CKD assessment before surgery.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Chronic kidney disease (CKD) is common in patients undergoing aortic valve replacement (AVR).
  • Assessing the impact of AVR on kidney function is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the effect of AVR on estimated glomerular filtration rate (eGFR).
  • To determine if CKD reversibility after AVR impacts postoperative outcomes.

Main Methods:

  • Retrospective review of 2169 patients undergoing isolated AVR (2000-2012).
  • Patients categorized by preoperative eGFR: NoCKD (>60), ModCKD (30-60), and SevCKD (15-30).
  • Exclusion of end-stage renal disease patients (eGFR <15 or on dialysis).

Main Results:

  • NoCKD patients experienced a postoperative eGFR decline, stabilizing within a year.
  • ModCKD and SevCKD patients showed initial eGFR improvement post-AVR, peaking at 1 week.
  • Despite slight declines, eGFR remained improved over baseline at 1 year (ModCKD) and 6 months (SevCKD).
  • CKD reversibility correlated with improved long-term survival in ModCKD and short-term survival in SevCKD.

Conclusions:

  • AVR leads to significant initial eGFR improvement, sustained in moderate and severe CKD patients.
  • This improvement in kidney function is associated with enhanced patient survival.
  • The potential for CKD reversibility necessitates careful preoperative risk assessment in AVR candidates.
Abstract

Keywords:
Aortic valve replacementOutcomesRenal failure

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