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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Acute kidney injury post-transcatheter aortic valve replacement
Pradhum Ram1, Kenechukwu Mezue1, Gregg Pressman2
1Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania.
Clinical Cardiology
|December 19, 2017
Summary
Acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR) increases mortality and hospital costs. This review summarizes recent literature on AKI prevalence, causes, and outcomes following TAVR to guide future prevention strategies.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis, expanding to intermediate-risk patients.
- Acute kidney injury (AKI) post-TAVR is associated with significantly poorer patient outcomes.
- Understanding AKI's impact is crucial given TAVR's increasing utilization.
Purpose of the Study:
- To review the prevalence and impact of AKI following TAVR.
- To synthesize recent literature on AKI causes and outcomes after TAVR.
- To inform strategies for reducing procedural complications and improving patient results.
Main Methods:
- Comprehensive literature search across MEDLINE, Google Scholar, and PubMed.
- Inclusion of recent studies relevant to AKI following TAVR.
- Analysis of identified literature for AKI prevalence, causes, and patient outcomes.
Main Results:
- AKI following TAVR is linked to increased 30-day and 1-year mortality.
- Patients experiencing AKI post-TAVR face longer hospital stays and higher costs.
- Identified causes include hemodynamic instability, transfusions, embolization, and contrast media use.
Conclusions:
- AKI significantly worsens outcomes after TAVR, increasing mortality and healthcare resource utilization.
- Current preventive measures like hydration and careful contrast use show limited success.
- Further research and refined techniques are needed to mitigate AKI risk in TAVR patients.
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