Abstract
Acute kidney injury (AKI) frequently occurs after cardiac surgery. Recently, transcatheter aortic valve implantation (TAVI), a less invasive option for aortic stenosis (AS), has been increasingly performed, particularly in elderly patients. We retrospectively investigated and compared the incidence and risk factors of postoperative AKI in patients who underwent surgical aortic valve replacement (SAVR) and TAVI. This was a retrospective single-center study. Seven days postoperatively, data were obtained from medical records. Patients were classified into SAVR and TAVI groups based on age, according to the policy of the Japanese Circulation Society. A total of 155 patients underwent surgery for AS between January 2020 and December 2021. Variables included age, sex, risk score, preoperative left ventricular ejection fraction, hypertension, and renal dysfunction. AKI was defined in accordance with the Kidney Disease: Improving Global Outcomes criteria. A total of 33 SAVR and 79 TAVI procedures were included in this study. The incidences of AKI in the SAVR and TAVI groups were 45.5% and 43.0%, respectively. No significant differences existed between the two groups. Weight (p = 0.0392) and pre-renal dysfunction (p = 0.0308) affected the incidence of AKI in the SAVR group, whereas no such variables were identified in the TAVI group. Within the current age-based treatment selection criteria for AS, no significant difference in the incidence of AKI was observed between the two procedures.Although preoperative renal function may be associated with postoperative AKI, further studies are required to select the optimal surgical procedure for patients with renal dysfunction.
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References
Engoren M, Habib RH, Arslanian-Engoren C, Kheterpal S, Schwann TA (2014) The effect of acute kidney injury and discharge creatinine level on mortality following cardiac surgery. Crit Care Med 42:2069–2074
Brown JR, Hisey WM, Marshall EJ, Likosky DS, Nichols EL, Everett AD, Pasquali SK, Jacobs ML, Jacobs JP, Parikh CR (2016) Acute kidney injury severity and long-term readmission and mortality after cardiac surgery. Ann Thorac Surg 102:1482–1489
Joseph J, Naqvi SY, Giri J, Goldberg S (2017) Aortic stenosis: pathophysiology, diagnosis, and therapy. Am J Med 130:253–263
Eveborn GW, Schirmer H, Heggelund G, Lunde P, Rasmussen K (2013) The evolving epidemiology of valvular aortic stenosis. The Tromsø study. Heart 99:396–400
Ribeiro GS, Melo RD, Deresz LF, Dal Lago P, Pontes MR, Karsten M (2017) Cardiac rehabilitation programme after transcatheter aortic valve implantation versus surgical aortic valve replacement: systematic review and meta-analysis. Eur J Prev Cardiol 24:688–697
Pressler A, Forschner L, Hummel J, Haller B, Christle JW, Halle M (2018) Long-term effect of exercise training in patients after transcatheter aortic valve implantation: follow-up of the SPORT:TAVI randomised pilot study. Eur J Prev Cardiol 25:794–801
Izumi C, Eishi K, Ashihara K, Arita T, Otsuji Y, Kunihara T, Komiya T, Shibata T, Seo Y, Daimon M, Takanashi S, Tanaka H, Nakatani S, Ninami H, Nishi H, Hayashida K, Yaku H, Yamaguchi J, Yamamoto K, Watanabe H, Abe Y, Amaki M, Amano M, Obase K, Tabata M, Miura T, Miyake M, Murata M, Watanabe N, Akasaka T, Okita Y, Kimura T, Sawa Y, Yoshida K, Japanese Circulation Society Joint Working Group (2020) JCS/JSCS/JATS/JSVS 2020 guidelines on the management of valvular heart disease. Circ J 84:2037–2119
Rosner MH, Okusa MD (2006) Acute kidney injury associated with cardiac surgery. Clin J Am Soc Nephrol 1:19–32
Karkouti K, Wijeysundera DN, YauTM CJL, Cheng DC, Crowther M, Dupuis J-Y, Fremes SE, Kent B, Laflamme C, Lamy A, Legare J-F, Mazer CD, McCluskey SA, Rubens FD, Sawchuk C, Beattie WS (2009) Acute kidney injury after cardiac surgery: focus on modifiable risk factors. Circulation 119:495–502
McCullough PA, Choi JP, Feghali GA, Schussler JM, Stoler RM, Vallabahn RC, Mehta A (2016) Contrast-induced acute kidney injury. J Am Coll Cardiol 68:1465–1473
KDIGO (2012) Clinical practice guideline for acute kidney injury. Kidney Int Suppl 2:1–138
Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA, American Society of Health-System Pharmacists; Infectious Disease Society of America; Surgical Infection Society; Society for Healthcare Epidemiology of America (2013) Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm 70:195–283
Massoth C, Zarbock A, Meersch M (2021) Acute kidney injury in cardiac surgery. Crit Care Clin 37:267–278
Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Williams M, Dewey T, Kapadia S, Babaliaros V, Thourani VH, Corso P, Pichard AD, Bavaria JE, Herrmann HC, Akin JJ, Anderson WN, Wang D, Pocock SJ, PARTNER Trial Investigators (2011) Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 364:2187–2198
Wang Y, Bellomo R (2017) Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nat Rev Nephrol 13:697–711
Yuan SM (2019) Acute kidney injury after cardiac surgery: risk factors and novel biomarkers. Braz J Cardiovasc Surg 34:352–360
Garcia S, Cubeddu RJ, Hahn RT, Ternacle J, Kapadia SR, Kodali SK, Thourani VH, Jaber WA, Asher CR, Elmariah S, Makkar R, Webb JG, Herrmann HC, Lu M, Devireddy CM, Malaisrie SC, Smith CR, Mack MJ, Sorajja P, Cavalcante JL, Goessl M, Shroff GR, Leon MB, Pibarot P (2021) 5-Year outcomes comparing surgical versus transcatheter aortic valve replacement in patients with chronic kidney disease. JACC Cardiovasc Interv 14(18):1995–2005
Pistolesi V, Regolisti G, Morabito S, Gandolfini I, Corrado S, Piotti G, Fiaccadori E (2018) Contrast medium induced acute kidney injury: a narrative review. J Nephrol 31:797–812
Lee SR, Zhuo H, Zhang Y, Dahl N, Dardik A, Ochoa Chaar CI (2020) Risk factors and safe contrast volume thresholds for postcontrast acute kidney injury after peripheral vascular interventions. J Vasc Surg 72:603–610
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This study was approved by the local Ethics Committee at the Saitama International Medical Center, Saitama Medical University, Japan. The study protocol (No. 2022-026), also approved the opt-out method of informed consent.
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Nomi, T., Kitamura, A., Tsujita, M. et al. Comparison of the effect of surgical versus transcatheter aortic valve replacement on the development of postoperative acute kidney injury. Heart Vessels 39, 359–364 (2024). https://doi.org/10.1007/s00380-023-02334-w
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DOI: https://doi.org/10.1007/s00380-023-02334-w