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Kidney Function Following percutaneous transcatheter aortic valve implantation (TAVI) in hospitalized patients
Session:
SESSÃO DE POSTERS 24 - COMPLICAÇÕES NA INTERVENÇÃO VALVULAR AÓRTICA PERCUTÂNEA
Speaker:
C. Santos-Jorge
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.6 Valvular Heart Disease – Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
C. Santos-Jorge; Samuel Azevedo; Maria Rita Lima; Márcia Presume; Rui Miguel Gomes; André Moniz Garcia; Rita Amador; Joana Certo Pereira; Miguel S. Domingues; Marisa Trabulo; Rui Campante Teles; Jorge Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><u>Background:</u> </span></span></span><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000">Severe aortic stenosis leads to reduced renal perfusion, which can impact renal function, particularly in elderly patients with pre-existing chronic kidney disease (CKD). The impact of renal function on the prognosis of percutaneous transcatheter aortic valve implantation (TAVI) is significant and can influence short- and long-term outcomes. This study evaluated the impact of TAVI on kidney function in patients with severe aortic stenosis presenting with critical symptoms requiring hospital admission.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><u>Methods:</u> </span></span></span><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000">Retrospective observational cohort study of 171 hospitalized patients who underwent non-elective TAVI in a single tertiary center between January 2020 and December 2023. Median hospital stay was 12 days (IQR 3-21) and TAVI was performed at a median of 12 days post-admission (IQR 1-14). We evaluated estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula at admission, discharge and follow-up. Patients were divided according to their baseline estimated glomerular filtration rate (eGFR) (mL/min/1.73m<sup>2</sup>) into 3 groups: Group 1 with eGFR ≥ 60; Group 2 with 30 ≤ eGFR < 60; and Group 3 with eGFR < 30. Patients undergoing dialysis prior to the procedure and those without a follow-up of at least six months were excluded. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><u>Results:</u> </span></span></span><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000">A total of 171 patients (83±6 years, 54% women) were included. Patients in group 1 showed no significant change in eGFR between six months and one year after the procedure compared to baseline (76,82 ± 10,94 to 75,73 ± 14,33 mL/min/1.73m²). Group 2 and group 3 experienced significant improvement in mean eGFR at discharge and sustained improvement at six months to one-year post-TAVI (p<0.001). At six months to one-year post-TAVI, mean eGFR in group 2 increased from 43.98 ± 8.57 to 51.73 ± 16.42 mL/min/1.73m², while in group 3, it increased from 21.86 ± 5.25 to 32.59 ± 13.06 mL/min/1.73m².</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><u>Conclusions:</u> </span></span></span><span style="font-size:12pt"><span style="color:#000000"><span style="font-family:Aptos,sans-serif">In high-risk patients hospitalized urgently for TAVI, renal dysfunction is highly prevalent. Optimizing renal function and minimizing contrast use should be prioritized. Our study demonstrated a significant improvement in post-procedure renal function in patients with CKD at stage 3 or higher. These findings suggest a potential for renal function recovery, which may influence therapeutic decision-making in this population.</span></span></span></p>
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