Introduction
Incidence
Pathogenesis
Study | Design | Outcomes |
---|---|---|
Oguri A. 2015 | Retrospective cohort study (n = 2929), France2 registry | CKD 3b, 4, and 5 correlate with poor outcome and are considered a significant risk for TAVI |
Merchant, A.M. 2019 | Retrospective cohort study, single-center study (n = 116) | Transfusion of pRBCs but not nadir perioperative Hgb independently associated with post-TAVR AKI (OR = 1.67 per unit, 95% CI 1.13–2.47; p = 0.01) |
Crimi G. 2022 | Prospective cohort study, multi-center study (n = 2696) | Both AKI and CKD significantly and independently affected primary outcome (HR, 3.06 [95% CI, 2.01–4.64], p < 0.001 and HR, 1.82 [95% CI 1.27, 2.65], p < 0.01, respectively) |
Alzu’bi H. 2022 | Systematic review and meta-analysis (36 studies, n = 70,406) | AKI was documented in 4857 out of 50,395 (9.6%) patients that underwent TF TAVR compared to 3155 out of 19,721 (16%) patients who underwent TA-TAVR, with a risk ratio of 0.49 (95% CI, 0.36–0.66; p < 0.00001) |
Wang, Jiayang. 2017 | Systematic review and meta-analysis (n = 13 studies) | A total of 9 factors were associated significantly with an increased risk for post-TAVI AKI, including New York Heart Association (NYHA) class IV (OR 7.77, 95% CI 3.81–15.85; p < 0.0001), previous CKD (OR 2.81; 95% CI 1.96–4.03, p < 0.0001), requirement of red blood cell transfusion (OR 2.03, 95% CI 1.59–2.59, p < 0.0001), previous peripheral vascular disease (PVD) (OR 1.72, 95% CI 1.39–2.14, p < 0.0001), previous hypertension (OR 1.66, 95% CI 1.20–2.31, p = 0.002), previous atrial fibrillation (OR 1.63, 95% CI 1.11–2.39, p = 0.012), previous congestive heart failure (OR 1.51, 95% CI 1.09–2.10, p = 0.013), previous diabetes mellitus (OR 1.34, 95% CI 1.11–1.61, p = 0.002), and previous stroke (OR 1.29, 95% CI 1.02–1.62, p = 0.032) |
Preprocedural Risk Factors
Intraprocedural Risk Factors
Postprocedural Risk Factors
Modifiable risk factors | Non-modifiable risk factors | |
---|---|---|
1 | Access method | Preexisting heart failure |
2 | Perioperative hypotension events | Peripheral artery disease |
3 | Preoperative anemia needed blood transfusion | Diabetes mellitus |
4 | Rapid pacing during balloon-expandable valve deployment | Aortic atheroma burden |
5 | Intraoperative bleeding causes hemodynamic changes | Chronic kidney disease |