Related Experiment Video

Updated: Jun 19, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

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

Published on: August 8, 2025

Understanding Outcomes in Hemodialysis Patients Who Underwent Transcatheter Aortic Valve Replacement With the Latest

Juri Iwata1, Masanori Yamamoto2, Kei Kamata1

  • 1Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.

JACC. Asia
|June 18, 2026
PubMed

Insights

Hemodialysis patients undergoing transcatheter aortic valve replacement (TAVR) have similar outcomes to non-dialysis patients after accounting for comorbidities. This suggests that underlying health issues, not just dialysis itself, contribute to poorer prognoses in these high-risk individuals.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Nephrology

Background:

  • Transcatheter aortic valve replacement (TAVR) outcomes in hemodialysis (HD) patients are debated, especially with newer devices.
  • Existing data on HD patients undergoing TAVR show a generally poor prognosis.

Purpose of the Study:

  • To compare 1-year clinical outcomes after TAVR using the latest generation devices in HD versus non-HD patients.
  • To assess the impact of HD on TAVR outcomes after adjusting for baseline characteristics.

Main Methods:

  • A multicenter registry (OCEAN-TAVI) identified 760 HD and 3,928 non-HD patients.
  • 1:1 propensity score matching (PSM) was used to create balanced groups of 490 patients each.
  • The primary endpoint was 1-year all-cause mortality; secondary endpoints included cardiovascular death, stroke, and heart failure rehospitalization.

Main Results:

  • Initially, HD patients had significantly higher 1-year mortality (13.8% vs 4.8%).
  • After PSM, the 1-year mortality difference was attenuated (12.0% vs 13.3%, P=0.858).
  • No significant differences in secondary endpoints were observed post-PSM, though HD was an independent predictor before matching.

Conclusions:

  • The negative prognostic impact of hemodialysis on TAVR outcomes diminishes after adjusting for baseline risk factors.
  • Poor outcomes in HD patients undergoing TAVR are likely due to a higher burden of comorbidities.
  • Careful patient selection and realistic prognostic assessment are crucial when considering TAVR for high-risk populations, including those on HD.
Abstract

Keywords:
aortic valve stenosisballoon-expandable valveshemodialysisself-expandable valvestranscatheter aortic valve replacement

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