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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

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Impact of Pre-existing Kidney Dysfunction on Outcomes Following Transcatheter Aortic Valve Replacement

Ikechukwu A Ifedili1, Oluwaseyi Bolorunduro1, Tamunoinemi Bob-Manuel1

  • 1Division of Cardiovascular Diseases, Department of Medicine, University of Tennessee Health Science Center/Methodist University Hospital, Mempis, Tennessee. United States.

Current Cardiology Reviews
|August 8, 2017
PubMed

Insights

Patients with chronic kidney disease (CKD) undergoing transcatheter aortic valve replacement (TAVR) face higher risks of mortality and complications. Early identification and management of CKD are crucial for improving TAVR outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Pre-existing chronic kidney disease (CKD) is associated with poor outcomes in heart valve surgery.
  • Evidence on CKD's impact on transcatheter aortic valve replacement (TAVR) outcomes is limited and conflicting.

Purpose of the Study:

  • To systematically evaluate the effect of pre-existing CKD on TAVR outcomes.
  • To compare 30-day and long-term outcomes in TAVR patients with and without CKD.

Main Methods:

  • Systematic electronic search adhering to PRISMA guidelines.
  • Inclusion of randomized controlled trials and observational studies.
  • Comparison of outcomes based on Glomerular Filtration Rate (GFR) <60 mL/min/1.73m² versus GFR ≥60 mL/min/1.73m².

Main Results:

  • Analysis of 10 studies involving 8688 patients.
  • CKD patients (GFR <60) showed significantly higher 30-day mortality (OR 1.40), cardiovascular mortality (OR 1.66), stroke (OR 1.39), acute kidney injury (OR 1.42), and dialysis risk (OR 2.13).
  • One-year all-cause mortality was also higher in CKD patients (OR 1.80); no differences observed in device success, bleeding, vascular complications, pacemaker needs, or paravalvular leaks.

Conclusions:

  • Pre-existing CKD (GFR <60) strongly predicts worse short- and long-term outcomes post-TAVR.
  • Proactive strategies are necessary to mitigate risks in TAVR patients with CKD.
Abstract

Keywords:
Aortic stenosisPRISMAchronic kidney diseaseglomerular filtrationreplacementtranscatheter aortic valve replacement

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