Long- term clinical outcomes after Transcatheter Aortic Valve Implantation (TAVI) in Patients with chronic renal failure
OBJECTIVES: In our work we aimed at studying short- and long- term clinical outcomes, particularly the mortality incidence, in patients with chronic renal failure undergoing transcatheter aortic valve implantation. METHODS: Between December 2007 and Mars 2015 a total number of 320 Patients with severe aortic stenosis who underwent transapical TAVI with Edwards Sapiens or Symetis were collected. Of these 101 have chronic renal failure (class I – IV according to KDOQI classification), and 219 without renal failure. Baseline characteristics and the clinical outcomes were recorded. Chronic renal failure was defined according to the KDOQI classification. All individuals with GFR <60 mL/min/1.73 m2 for more than 3 months are classified as having chronic kidney disease, irrespective of the presence or absence of kidney damage. With divided our study population into two groups. The mean age of group 1 (patients without renal failure) was 80±5.5 years. The mean age of group 2 (patients with chronic renal failure) was 79±6.8. All patients were nonoperable or had a high risk for a conventional aortic valve replacement. The mean logistic Euro- SCORE I was 29±11.5 for group 1, and 37±16 for group 2. RESULTS: Baseline chronic renal failure, irrespective of the preoperative stage, was associated with significantly increased overall mortality rate (30- day and 1- year mortality) in comparison to those patients without a known renal failure (P = 0.002). In our work we observed a significant difference between Group I and Group II in the incidence of cardiovascular Death (p=0,014), in the incidence of acute renal failure (p=0,000), in the incidence of vascular complications (p=0,020) and in the incidence of acute heart failure (p=0,001). There was no significant difference between the two Groups in the rate of permanent pacemaker implantation, bleeding, and postoperative hospital stay. CONCLUSIONS: Chronic kidney disease correlates with poor clinical outcomes after TAVI and could be considered as a significant risk for TAVI.
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