Impact of Chronic Kidney Disease on Decision Making and Management in Transcatheter Aortic Valve Interventions

Area of Science:

• Cardiology
• Nephrology
• Interventional Cardiology

Background:

• The prevalence of chronic kidney disease (CKD) and severe aortic stenosis (AS) is increasing.
• CKD and AS have a bidirectional relationship, with each condition potentially worsening the other.
• Transcatheter aortic valve implantation (TAVI) is increasingly used for severe AS, presenting unique challenges in patients with CKD.

Purpose of the Study:

• To review the current literature on TAVI in patients with concomitant severe AS and CKD.
• To focus on the decision-making process and specific risks associated with TAVI in this patient cohort.
• To provide practical strategies for managing patients with both severe AS and CKD undergoing TAVI.

Main Methods:

• Literature review of studies concerning TAVI in patients with CKD.
• Analysis of diagnostic, therapeutic, and interventional considerations.
• Synthesis of current evidence and clinical recommendations.

Main Results:

• CKD significantly impacts diagnostic investigations and treatment decisions for TAVI.
• Specific risks related to TAVI procedures in CKD patients require careful consideration.
• Management strategies need to be tailored to the individual patient's renal function and cardiovascular status.

Conclusions:

• Optimal management of severe AS with TAVI in CKD patients requires a multidisciplinary approach.
• Careful pre-procedural assessment and risk stratification are crucial.
• Further research is needed to refine TAVI techniques and post-procedural care in this complex population.