Author + information
- Darien Paone,
- Binita Shah,
- Daniel McDonald,
- Rahul Thakker,
- Pascale Houanche,
- Peter Neuburger,
- Muhamed Saric,
- Cezar Staniloae,
- Hasan Jilaihawi,
- Michael Querijero and
- Mathew Williams
Background: Outcomes after transcatheter aortic valve replacement (TAVR) in patients with renal insufficiency but not on dialysis remain uncertain.
Methods: Retrospective chart review identified 209 patients who underwent TAVR between September 2014 and September 2015. Of these patients, 5 (2.4%) were excluded for history of hemodialysis. Of the 204 patients, 106 (52%) had glomerular filtration rate (GFR) <60 mL/min/1.73m2 and 98 (48%) had GFR >60 mL/min/1.73m2 on clinical laboratory testing. Outcomes were defined by the valve academic research consortium-2 criteria when applicable and compared between low and normal GFR groups via test of proportions. Median follow-up was 353 days. Continuous data are shown as median [interquartile range] and categorical data are shown as proportions.
Results: The 30-day mortality risk by Society of Thoracic Surgery score was significantly higher in the low versus high GFR groups (6.7% [5.2–8.9] vs 5.2% [3.4–7.0], p<0.001), while contrast use was significantly lower in the low versus normal GFR groups (34 mL [26–45] vs 43 mL [32–59], p=0.003). There were no significant differences in outcomes (Table).
Conclusions: In a high-volume center the rate of adverse outcomes, including acute renal failure, was overall low with no significant difference between non-dialysis patients with low versus high baseline GFR undergoing TAVR. Procedural modifications may allow for judicious use of contrast without an increase in adverse outcomes in patients with low GFR.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-176
- 2017 American College of Cardiology Foundation