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Transcatheter Aortic Valve Replacement in Patients with Chronic Kidney Disease: Pre-procedural Assessment and Procedural Techniques to Minimize Risk for Acute Kidney Injury

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Book cover Multimodality Imaging for Transcatheter Aortic Valve Replacement

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Abstract

Transcatheter aortic valve replacement (TAVR) offers treatment for high-risk patients with severe symptomatic aortic stenosis [1, 2]. Currently, TAVR is performed in high-risk patients with multiple comorbidities and advanced age. These patients frequently have abnormal baseline renal function and are therefore at increased risk for acute kidney injury (AKI) after TAVR due to the significant hemodynamic changes during the procedure and use of contrast agents [3].

AKI following TAVR is a frequent complication that occurs in >10 % of patients. These patients suffer from significantly worse outcome with higher rates of mortality in patients who develop AKI [4–7]. Based on this current evidence, it is imperative to minimize the risks for kidney injury during the TAVR evaluation process and during the TAVR procedure itself. In this chapter, we will summarize and suggest advanced approaches to minimize AKI based on the current evidence base and our own institutional experience.

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Author information

Authors and Affiliations

  1. Department of Interventional Cardiology, Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC, 20010, USA

    Israel M. Barbash MD, Danny Dvir MD, Wm. Guy Weigold MD, FACC, FSCCT, Lowell F. Satler, Ron Waksman MD, FACC & Augusto D. Pichard MD, FACC

  2. Department of Cath Lab, Washington Hospital Center, 10 Irving St, Washington, DC, 20010, USA

    Israel M. Barbash MD

  3. Department of Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC, 20010, USA

    Danny Dvir MD & Wm. Guy Weigold MD, FACC, FSCCT

  4. Department of Cardiology, MedStar Washington Hospital Center, MedStar Heart Institute, Georgetown University, 110 Irving Street, NW, Suite 4B-1, Washington, DC, 20010, USA

    Ron Waksman MD, FACC

  5. Department of Cardiology, Georgetown University Medical School, MedStar Washington Hospital Center, Washington, DC, USA

    Augusto D. Pichard MD, FACC

Authors
  1. Israel M. Barbash MD
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  2. Danny Dvir MD
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  3. Wm. Guy Weigold MD, FACC, FSCCT
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  4. Lowell F. Satler
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  5. Ron Waksman MD, FACC
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  6. Augusto D. Pichard MD, FACC
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Corresponding author

Correspondence to Augusto D. Pichard MD, FACC .

Editor information

Editors and Affiliations

  1. NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA

    James K. Min

  2. Departments of Imaging and Medicine, David Geffen UCLA School of Medicine, Cedars-Sinai Medical Center Cedars-Sinai Heart Institute, Los Angeles, California, USA

    Daniel S. Berman

  3. Department of Cardiology, St. Paul’s Hospital, University of British Columbia Department of Radiology, Vancouver, British Columbia, Canada

    Jonathon Leipsic

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© 2014 Springer-Verlag London

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Barbash, I.M., Dvir, D., Weigold, W.G., Satler, L.F., Waksman, R., Pichard, A.D. (2014). Transcatheter Aortic Valve Replacement in Patients with Chronic Kidney Disease: Pre-procedural Assessment and Procedural Techniques to Minimize Risk for Acute Kidney Injury. In: Min, J., Berman, D., Leipsic, J. (eds) Multimodality Imaging for Transcatheter Aortic Valve Replacement. Springer, London. https://doi.org/10.1007/978-1-4471-2798-7_19

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  • DOI: https://doi.org/10.1007/978-1-4471-2798-7_19

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2797-0

  • Online ISBN: 978-1-4471-2798-7

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