1
|
Matsuura K, Yamamoto H, Matsumiya G, Motomura N. Descriptive analysis of long-term survival after aortic valve replacement for dialysis patients: importance of renal pathologies and age. Gen Thorac Cardiovasc Surg 2024; 72:577-584. [PMID: 38451409 PMCID: PMC11339135 DOI: 10.1007/s11748-024-02011-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES This study analyzed the long-term survival of dialysis patients undergoing AVR using the Japanese National Clinical Database with additional survival data. METHODS De-novo AVR for dialysis-dependent patients between 2010 and 2012 who were registered in the Japan Cardiovascular Surgery Database were included. Concomitant aortic surgery and transcatheter aortic valve replacement were excluded. An additional questionnaire was sent to each hospital regarding the underlying kidney disease, the duration of dialysis initiation to the surgery, and clinical outcomes. The Kaplan-Meier survival curve was descriptively shown for all cohorts and each renal pathology. Furthermore, we compared the incidence of bioprosthetic valve failure in patients who were < 65 years old (group Y) and ≧65 years old (group O). RESULTS Of these 1529 patients, diabetic nephropathy was 517, chronic glomerulonephritis was 437, and renal sclerosis was 210, regarding renal pathology. 1, 3, and 5-year survival in each pathology was 78.4%, 58.6%, 45.9% in diabetic nephritis, 78.8%, 68.4%, 58.2% in chronic glomerulonephritis, 79.0%, 67.8%, 52.1% in renal sclerosis, and 74.4%, 62.6%, 49.2% in others. Active infectious endocarditis was more prevalent in group Y (O 2.7% vs. Y 9.6%). The incidence of bioprosthetic valve failure requiring re-hospitalization was too small to analyze. 1, 3, and 5-year survival was 76.0%, 63.4%, 49.2% in group O and 74.3%, 64.2%, and 47.7% in group Y. CONCLUSIONS Long-term survival of AVR for dialysis-dependent was higher in patients with chronic glomerulonephritis and lower in patients with diabetic nephritis than in other pathologies.
Collapse
Affiliation(s)
- Kaoru Matsuura
- Department of Cardiovascular Surgery, Chiba University Hospital, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba Prefecture, 260-0856, Japan.
| | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Hospital, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba Prefecture, 260-0856, Japan
| | - Noboru Motomura
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Chiba, Japan
| |
Collapse
|
2
|
Wiechmann RJ, Lee LY, Yu Y, Prillinger JB, Gutfinger D, Blakeman B. Ten-year outcomes of surgical aortic valve replacement with a contemporary supra-annular porcine valve in a Medicare population. JTCVS OPEN 2022; 12:84-102. [PMID: 36590734 PMCID: PMC9801294 DOI: 10.1016/j.xjon.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 01/04/2023]
Abstract
Objective Bioprosthetic surgical aortic valve replacement remains an important treatment option in the era of transcatheter interventions. Real-world outcomes are not well characterized because of limited prospective follow-up studies. We present the 10-year clinical outcomes of Medicare beneficiaries undergoing surgical aortic valve replacement with a contemporary supra-annular porcine valve. Methods This is a single-arm observational study using Medicare fee-for-service claims data. De-identified patients undergoing surgical aortic valve replacement with the Epic Supra valve (Abbott) in the United States between January 1, 2008, and December 31, 2019, were selected by International Classification of Diseases 9th and 10th Revision procedure codes and then linked to a manufacturer device tracking database. All-cause mortality, heart failure rehospitalization, and aortic valve reintervention (surgical or transcatheter valve-in-valve) were evaluated at 10 years using the Kaplan-Meier method. Results Among 272,591 Medicare beneficiaries undergoing surgical aortic valve replacement during the study period, 11,685 received the Epic Supra valve, of whom 51.6% (6029) had underlying heart failure. Mean age was 76 ± 7 years. Survival at 10 years in patients without preoperative heart failure was 43.5% (95% confidence interval, 41.8-45.2) compared with 24.1% (95% confidence interval, 22.6-25.5) for patients with heart failure (P < .001). The 10-year freedom from heart failure rehospitalization was 64.0% (95% confidence interval, 62.6-65.3). Freedom from aortic valve reintervention was 94.6% (95% confidence interval, 93.8-95.3) at 10 years. Conclusions This real-world nationwide study of US Medicare beneficiaries receiving the Epic Supra valve demonstrates more than 94% freedom from all-cause valve reintervention and 64% freedom from heart failure rehospitalization at 10 years postimplant. Long-term survival and heart failure rehospitalization in this population with aortic valve disease undergoing surgical aortic valve replacement were found to be impacted by underlying heart failure.
Collapse
Key Words
- CABG, coronary artery bypass grafting
- CI, confidence interval
- CMS, Centers for Medicare & Medicaid Service
- FFS, fee-for-service
- HF, heart failure
- HR, hazard ratio
- ICD-10, International Classification of Diseases, Tenth Revision
- ICD-9, International Classification of Diseases, Ninth Revision
- LVAD, left ventricular assist device
- SAVR, surgical aortic valve replacement
- TAVI, transcatheter aortic valve implantation
- VIV, valve-in-valve
- aortic valve replacement
- durability
- heart failure
- porcine valve
- survival
Collapse
Affiliation(s)
- Robert J. Wiechmann
- Mayo Clinic Health System, Cardiothoracic Surgery, Eau Claire, Wis,Address for reprints: Robert J. Wiechmann, MD, Mayo Clinic Health System, 1400 Bellinger St, Eau Claire, WI 54702.
| | - Leonard Y. Lee
- Division of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | | | | | | |
Collapse
|
3
|
Ogami T, Kurlansky P, Takayama H, Ning Y, Zimmermann E, Zhu RC, Ali ZA, Nazif TM, Vahl TP, Avgerinos DV, Smith CR, Leon MB, Kodali SK, George I. Three-year survival of transcatheter versus surgical aortic valve replacement in dialysis. Catheter Cardiovasc Interv 2022; 99:1206-1213. [PMID: 35084101 DOI: 10.1002/ccd.30045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/09/2021] [Accepted: 11/27/2021] [Indexed: 12/19/2022]
Abstract
To highlight the trends of surgical (open) aortic valve replacement (SAVR) as well as to compare the outcome between transcatheter aortic valve replacement (TAVR) and SAVR in elderly dialysis patients. TAVR has evolved as an effective alternative to surgery (SAVR) for aortic stenosis. We identified dialysis-dependent patients who underwent SAVR or TAVR from 2000 to 2015 from the United States Renal Data System using ICD-9 codes. We defined high-risk surgical patients as age over 70 or older. The primary endpoint was survival at 3 years and we compared the outcome between SAVR and TAVR groups using inverse probability of treatment weighting (IPTW). A total of 4332 and 1280 dialysis patients underwent SAVR and TAVR, respectively, during the study period. Among SAVR cohort, 3312 patients underwent SAVR before June 2012 and 1020 after June 2012. In-hospital mortality was significantly worse before 2012 (14.6% vs. 11.3% after 2012, p = 0.007) as well as estimated 3-year mortality (69.1% vs. 60.3% after 2012, p < 0.001). After June 2012, the TAVR cohort was older and had more comorbidities including coronary artery disease and congestive heart failure compared to the SAVR cohort. After IPTW, in-hospital mortality was significantly lower after TAVR versus SAVR (odds ratio 0.38 [95% confidence interval [CI], 0.27-0.52], p < 0.001). However, TAVR had a significantly higher risk of 3-year mortality than SAVR (hazard ratio 1.24 [95% CI 1.1-1.39], p < 0.001). TAVR may be a reasonable and potentially preferable alternative to SAVR in the elderly dialysis population in the short-term period.
Collapse
Affiliation(s)
- Takuya Ogami
- Department of Surgery, New York-Presbyterian/Queens, Flushing, USA
| | - Paul Kurlansky
- Division of Cardiothoracic Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Hiroo Takayama
- Division of Cardiothoracic Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Yuming Ning
- Division of Cardiothoracic Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Eric Zimmermann
- Department of Surgery, New York-Presbyterian/Queens, Flushing, USA
| | - Roger C Zhu
- Department of Surgery, New York-Presbyterian/Queens, Flushing, USA
| | - Ziad A Ali
- Division of Cardiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Tamim M Nazif
- Division of Cardiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Torsten P Vahl
- Division of Cardiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Dimitrios V Avgerinos
- Department of Cardiothoracic Surgery, New York-Presbyterian, Weill Cornell Medicine, New York, New York, USA
| | - Craig R Smith
- Division of Cardiothoracic Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Martin B Leon
- Division of Cardiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Susheel K Kodali
- Division of Cardiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | - Isaac George
- Division of Cardiothoracic Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| |
Collapse
|
4
|
Allana SS, Alkhouli M, Alli O, Coylewright M, Horne A, Ijioma N, Kadavath S, Pineda AM, Sanchez C, Schreiber TL, Shah AP, Smith C, Suradi H, Sylvia KE, Young M, Krishnan SK. Identifying opportunities to advance health equity in interventional cardiology: Structural heart disease. Catheter Cardiovasc Interv 2021; 99:1165-1171. [PMID: 34837459 DOI: 10.1002/ccd.30021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/12/2021] [Accepted: 11/04/2021] [Indexed: 11/10/2022]
Abstract
Health care practices are influenced by variety of factors. These factors that include social determinants, race and ethnicity, and gender not only affect access to health care but can also affect quality of care and patient outcomes. These are a source of health care disparities. This article acknowledges that these disparities exist in getting optimal care in structural heart disease, reviews the literature and proposes steps that can help reduce these disparities on personal and committee levels.
Collapse
Affiliation(s)
- Salman S Allana
- Division of Cardiology, Department of Medicine, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mohamad Alkhouli
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Olueseun Alli
- Novant Heart and Vascular Institute, Charlotte, North Carolina, USA
| | - Megan Coylewright
- Department of Cardiology, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Aaron Horne
- Division of Cardiology, Department of Medicine, Palestine Regional Medical Center, Palestine, Texas, USA
| | - Nkechi Ijioma
- Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sabeeda Kadavath
- Department of of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andres M Pineda
- Department of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Carlos Sanchez
- Heart and Vascular Service Line, OhioHealth - Riverside Methodist Hospital, Columbus, Ohio, USA
| | - Theodore L Schreiber
- Department of Cardiology, Ascension St. John Hospital Warren Family Physicians, Warren, Michigan, USA
| | - Atman P Shah
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Conrad Smith
- Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hussam Suradi
- Division of Cardiovascular Medicine, Department of Medicine, Rush University Medical Center/Rush Medical College, Chicago, Illinois, USA
| | - Kristyn E Sylvia
- The Society for Cardiovascular Angiography and Interventions, Washington, District of Columbia, USA
| | - Michael Young
- Division of Cardiology, Department of Medicine, Darthmouth-Hitchcock Health System, Lebanon, New Hampshire, USA
| | - Sandeep K Krishnan
- Director of Structural Heart Program, Heart and Vascular Institute, King's Daughters Medical Center, Ashland, Kentucky, USA
| |
Collapse
|
5
|
Balkan B, Magin H. What are the factors affecting the progression of kidney failure, mortality and morbidity after cardiac surgery in patients with chronic kidney disease? J Card Surg 2021; 36:2021-2028. [PMID: 33694184 DOI: 10.1111/jocs.15493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 01/11/2021] [Accepted: 02/28/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIM Acute kidney injury occurs in as many as 40% of patients after cardiac surgery and requires dialysis in 1% of cases and associated with an increased risk of mortality and morbidity, predisposes patients to a longer hospitalization, requires additional treatments, and increases the hospital costs. We aimed to investigate the factors affecting the progression of kidney disease during cardiac surgery in preoperative chronic kidney disease patients (CKD). METHODS The demographic data of patients and preoperatively studied parameters are: American Society of Anesthesiologists Classification, diabetes mellitus, hypertension, left ventricular ejection fractions, estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. The pre and postoperative parameters recorded were glucose, blood urea nitrogen (BUN), creatinine, hemoglobin, and eGFR. In the intensive care follow-up, discharge status, revision status and 30-day mortality rates and complications were analyzed. RESULTS One hundred and thirty-eight patients (87 males, 51 females; mean age 61.7 years) were included, the mean preoperative Euro score II value was 8.72 ± 7.09 (7.3 ± 6.2 in the survival group and 13.1 ± 7.9. 83 in the deceased group). The number of patients who underwent revision surgery due to postoperative bleeding were 36 (26.09%) and the 30-day surgical mortality was 24.64% (n = 34). CONCLUSION Age, complication, euro score, cross-clamp time, pulmonary artery pressure, postoperative BUN, creatine, and CKD-EPI-GFR were found to be significantly effective in predicting 30-day mortality of the patients.
Collapse
Affiliation(s)
- Bedih Balkan
- Department of Anesthesiology and intensive care, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and research Hospital, Saglık Bilimleri University, Istanbul, Turkey
| | - Hasan Magin
- Department of Nephrology, Karolinska University Hospital, Huddinge, Sweden
| |
Collapse
|
6
|
Kuno T, Takagi H, Ando T, Ueyama H, Fujisaki T, Kodaira M, Numasawa Y, Briasoulis A, Hayashida K. Short- and Long-term Outcomes in Dialysis Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-analysis. Can J Cardiol 2020; 36:1754-1763. [DOI: 10.1016/j.cjca.2020.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/30/2022] Open
|
7
|
Ando T, Briasoulis A, Takagi H, Telila T, Grines CL, Malik AH. Trends of utilization and outcomes after transcatheter and surgical aortic valve replacement on chronic dialysis. J Card Surg 2020; 35:3294-3301. [PMID: 32985742 DOI: 10.1111/jocs.15022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Trends of utilization and outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) for patients on chronic dialysis (CD) are not well described. We aimed to assess the trends in utilization and outcomes of TAVR and SAVR on CD. METHODS Nationwide Readmission Databases from 2013 to 2017 was analyzed. International Classification of Diseases Clinical Modification 9 and 10 codes were used to identify diagnoses and procedures. A multivariable regression model was used to compare the outcomes expressed as adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS A total of 5731 TAVR and 6491 SAVR were performed in patients with CD, respectively. The volume of TAVR increased by approximately four-folds and SAVR increased by approximately 33%. However, amongst patients with CD, the percentage of TAVR increased, whereas that of SAVR decreased (p < .001 for all). In 2016 and 2017, TAVR volume surpassed that of SAVR on CD. In-hospital mortality remained similar in TAVR (aOR: 0.92; 95% CI: 0.79-1.07; p-trend = .23) whereas it increased significantly in SAVR (aOR: 1.14: 95% CI: 1.05-1.25, p-trend = .002). In 2017, in-hospital mortality and 30-day readmission were significantly higher in TAVR among CD than non-CD patients. CONCLUSION Despite increased use of TAVR among CD, there still is an opportunity for improvement in outcome of aortic valve replacement for those on CD.
Collapse
Affiliation(s)
- Tomo Ando
- Division of Cardiology, Center for Interventional Vascular Therapy, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
| | | | - Hisato Takagi
- Division of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
| | - Tesfaye Telila
- Division of Interventional Cardiology, Piedmont Hospital, Atlanta, Georgia, USA
| | - Cindy L Grines
- Division of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA
| | - Aaqib H Malik
- Division of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| |
Collapse
|
8
|
Sanaiha Y, Khoubian JJ, Williamson CG, Aguayo E, Dobaria V, Srivastava N, Benharash P. Trends in Mortality and Costs of Pediatric Extracorporeal Life Support. Pediatrics 2020; 146:peds.2019-3564. [PMID: 32801159 DOI: 10.1542/peds.2019-3564] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Extracorporeal life support (ECLS) has been used for >30 years as a life-sustaining therapy in critically ill patients for a variety of indications. In the current study, we aimed to examine trends in use, mortality, length of stay (LOS), and costs for pediatric ECLS hospitalizations. METHODS We performed a retrospective cohort study of pediatric patients (between the ages of 28 days and <21 years) on ECLS using the 2008-2015 National Inpatient Sample, the largest all-payer inpatient hospitalization database generated from hospital discharges. Nonparametric and Cochran-Armitage tests for trend were used to study in-hospital mortality, LOS, and hospitalization costs. RESULTS Of the estimated 5847 patients identified and included for analysis, ECLS was required for respiratory failure (36.4%), postcardiotomy syndrome (25.9%), mixed cardiopulmonary failure (21.7%), cardiogenic shock (13.1%), and transplanted graft dysfunction (2.9%). The rate of ECLS hospitalizations increased 329%, from 11 to 46 cases per 100 000 pediatric hospitalizations, from 2008 to 2015 (P < .001). Overall mortality decreased from 50.3% to 34.6% (P < .001). Adjusted hospital costs increased significantly ($214 046 ± 11 822 to 324 841 ± 25 621; P = .002) during the study period despite a stable overall hospital LOS (46 ± 6 to 44 ± 4 days; P = .94). CONCLUSIONS Use of ECLS in pediatric patients has increased with substantially improved ECLS survival rates. Hospital costs have increased significantly despite a stable LOS in this group. Dissemination of this costly yet life-saving technology warrants ongoing analysis of use trends to identify areas for quality improvement.
Collapse
Affiliation(s)
- Yas Sanaiha
- Cardiovascular Outcomes Research Laboratory, Division of Cardiac Surgery, and
| | - Jonathan J Khoubian
- Cardiovascular Outcomes Research Laboratory, Division of Cardiac Surgery, and.,Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | | | - Esteban Aguayo
- Cardiovascular Outcomes Research Laboratory, Division of Cardiac Surgery, and
| | - Vishal Dobaria
- Cardiovascular Outcomes Research Laboratory, Division of Cardiac Surgery, and
| | - Neeraj Srivastava
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratory, Division of Cardiac Surgery, and
| |
Collapse
|
9
|
Kidney injury as post-interventional complication of TAVI. Clin Res Cardiol 2020; 110:313-322. [PMID: 32844282 DOI: 10.1007/s00392-020-01732-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/12/2020] [Indexed: 12/17/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) is an accepted treatment approach of aortic stenosis. In the beginning, this technique was executed in high-risk patients only. Today, intermediate-risk patients are also amenable for TAVI, as long as the transfemoral approach is chosen. Numerous predictors have been identified that could lead to periprocedural complications and are defined by patient co-morbidities as well as being inherent to the technical approach. Although vascular complications and postinterventional paravalvular regurgitation have been minimized over the past years by revised technologies and techniques, there is a prevailing individual risk brought about by the specific pathophysiology of the cardiorenal syndrome.
Collapse
|
10
|
Yamauchi T, Yamamoto H, Miyata H, Kobayashi J, Masai T, Motomura N. Surgical Aortic Valve Replacement for Aortic Stenosis in Dialysis Patients ― Analysis of Japan Cardiovascular Surgery Database ―. Circ J 2020; 84:1271-1276. [DOI: 10.1253/circj.cj-20-0042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takashi Yamauchi
- Department of Cardiovascular Surgery, Sakurabashi Watanabe Hospital
| | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Takafumi Masai
- Department of Cardiovascular Surgery, Sakurabashi Watanabe Hospital
| | - Noboru Motomura
- Department of Cardiovascular Surgery, Toho University, Sakura Medical Center
| |
Collapse
|
11
|
Khan MZ, Khan MU, Kalra A, Krupica T, Kaluski E, Khan SU. Transcatheter versus surgical aortic valve replacement in patients with end stage renal disease. Catheter Cardiovasc Interv 2020; 96:1102-1109. [PMID: 33034959 DOI: 10.1002/ccd.29109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/12/2020] [Accepted: 06/05/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To assess contemporary national trends of comorbidities, outcomes, and health care resource utilization in patients with aortic stenosis (AS) and end-stage renal disease (ESRD) undergoing transcatheter and surgical aortic valve replacement (TAVR and SAVR). METHODS AND RESULTS The National-Inpatient-Sample was used to study trends in patients with AS and ESRD undergoing TAVR and SAVR between January 2012 and December 2017. Of 12,550 patients, 5,735 underwent TAVR and 6,815 underwent SAVR. Over the years, the utilization of SAVR declined (from 82.0 to 37.7%); and increased for TAVR (from 18.0 to 62.3%; p < .001). Patients receiving TAVR were older (74.6 [9.1] vs. 66.8 years [9.1]), had a higher proportion of females (37.1 vs. 32.5%), Caucasians (68.7 vs. 60.9%) and Asian /Pacific Islanders (3.1 vs. 2.7%; p < .001 for all). The TAVR patients, despite having higher comorbidity burden (anemia, coronary artery disease, chronic pulmonary disease, congestive heart failure, cerebrovascular disease, and peripheral vascular disease) had lower inpatient mortality and complications (ST-elevation myocardial infarction, pneumonia, pneumothorax, pulmonary embolism, cardiogenic shock, cardiac arrest, and need for mechanical ventilators and vasopressors). The median length of stay (13.9-6.5 days; p < .001) and cost of stay ($311,538.16 to $255,693.40; p < .001) reduced with TAVR; but remained unchanged with SAVR. Higher proportion of patients was discharged home after TAVR vs. SAVR. CONCLUSION Among patients with AS and ESRD, despite providing therapy to subjects with higher comorbidity burden, TAVR was associated with lower inpatient mortality, complications, length of stay, cost of care, and higher home disposition rates when compared with SAVR.
Collapse
Affiliation(s)
- Muhammad Zia Khan
- Department of Medicine, West Virginia University, Morgantown, WV, USA
| | - Muhammad U Khan
- Department of Medicine, West Virginia University, Morgantown, WV, USA
| | - Ankur Kalra
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Troy Krupica
- Department of Medicine, West Virginia University, Morgantown, WV, USA
| | - Edo Kaluski
- Guthrie Clinic/Robert Packer Hospital, Sayre, Pennsylvania, USA.,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Safi U Khan
- Department of Medicine, West Virginia University, Morgantown, WV, USA
| |
Collapse
|
12
|
Gangadharan K, Parameswaranunni R, Merzkani M, Molmenti E, Bhaskaran M. Renal Transplantation after Transcatheter Aortic Valve Replacement: Case Report. Int J Angiol 2020; 29:55-57. [PMID: 32132818 DOI: 10.1055/s-0038-1670665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Patients with chronic kidney disease (CKD) have an increased likelihood of developing calcific aortic stenosis (AS). These patients also often suffer from multiple comorbidities, potentially making them high-risk surgical candidates and limiting their treatment options. Transcatheter aortic valve replacement (TAVR) is the recommended therapeutic approach for severe AS in patients who are not suitable candidates for surgical aortic valve replacement (SAVR). TAVR is being increasingly considered as a viable alternative to SAVR. As such, its applications in patients with CKD and other chronic diseases, as well as methods to optimize peri- and postoperative results are of great interest and significance. We present the case of a successful renal transplant procedure, performed within a year following a TAVR, in a 52-year-old man who suffered from multiple comorbidities.
Collapse
Affiliation(s)
| | | | - Massini Merzkani
- Department of Nephrology, North Shore University Hospital, Manhasset, New York
| | - Ernesto Molmenti
- Department of Surgery, North Shore University Hospital, Manhasset, New York
| | - Madhu Bhaskaran
- Department of Nephrology, North Shore University Hospital, Manhasset, New York
| |
Collapse
|
13
|
Surgical Therapy for Patients with Severe Aortic Stenosis in the Era of Transcatheter Aortic Valve Replacement. J UOEH 2019; 41:397-408. [PMID: 31866657 DOI: 10.7888/juoeh.41.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aortic stenosis (AS) is the most common valvular heart disease and is most frequently recognized among elderly people. Surgical aortic valve replacement (SAVR) is the most effective therapy, but its indication is sometimes difficult, and is impossible for high operative risk patients. Transcatheter aortic valve replacement (TAVR) was recently approved in Japan for high risk and inoperable patients with severe AS. TAVR is a less invasive method because it does not require a cardiopulmonary bypass and is associated with excellent surgical outcomes. In Western countries, the indication of TAVR has already been extended to moderate operative risk patients with severe AS, and is going to be further extended to low risk patients. The number of patients undergoing TAVR is increasing progressively, and there are effective alternative therapies for patients with severe AS. Selection of these surgical methods will be important in the near future. In regard to low operative risk patients especially, not only operative mortality, but also long-tern mortality and morbidity and quality of life should be taken into consideration. It is considered that some comorbidities in AS patients will be revealed to have an impact on surgical outcomes at the time when these surgical methods are selected. In this review, we examine end-stage renal disease on hemodialysis, functional tricuspid regurgitation, and sigmoid septum, and give an outline of what influence SAVR and TAVR have on the surgical outcomes of severe AS patients.
Collapse
|
14
|
Batchelor W, Anwaruddin S, Ross L, Alli O, Young MN, Horne A, Cestoni A, Welt F, Mehran R. Aortic Valve Stenosis Treatment Disparities in the Underserved. J Am Coll Cardiol 2019; 74:2313-2321. [DOI: 10.1016/j.jacc.2019.08.1035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 10/25/2022]
|
15
|
Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. A meta-analysis of ≥5-year mortality after transcatheter versus surgical aortic valve replacement. THE JOURNAL OF CARDIOVASCULAR SURGERY 2019; 61:107-116. [PMID: 31666501 DOI: 10.23736/s0021-9509.19.11030-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION It remains unclear whether long-term survival is superior following transcatheter aortic valve implantation (TAVI) than following surgical aortic valve replacement (SAVR). We performed a meta-analysis of mortality with ≥5-year follow-up in randomized controlled trials (RCTs) and propensity-score matched (PSM) studies of TAVI versus SAVR. EVIDENCE ACQUISITION MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through March 2019. Eligible studies were RCTs or PSM studies of TAVI versus SAVR enrolling patients with severe aortic stenosis and reporting all-cause mortality with ≥5-year follow-up as an outcome. A hazard ratio of mortality for TAVI versus SAVR was extracted from each individual study. EVIDENCE SYNTHESIS Our search identified 3 RCTs and 7 PSM studies enrolling 5498 patients. A pooled analysis of all 10 studies demonstrated a statistically significant 38% increase in mortality with TAVI relative to SAVR. A subgroup meta-analysis showed no statistically significant difference between TAVI and AVR in RCTs and a statistically significant 68% increase with TAVI relative to SAVR in PSM studies. CONCLUSIONS On the basis of a meta-analysis of 7 PSM studies, TAVI is associated with greater all-cause mortality with ≥5-year follow-up than SAVR. However, another meta-analysis of 3 RCTs suggests no difference in mortality between TAVI and SAVR.
Collapse
Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan - .,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan -
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Tomo Ando
- Department of Cardiology, Detroit Medical Center, Detroit, MI, USA
| | | |
Collapse
|
16
|
Cheng X, Hu Q, Zhao H, Qin S, Zhang D. Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Chronic Kidney Disease: A Meta-Analysis. J Cardiothorac Vasc Anesth 2019; 33:2221-2230. [DOI: 10.1053/j.jvca.2018.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Indexed: 11/11/2022]
|
17
|
Sanaiha Y, Mantha A, Ziaeian B, Juo YY, Shemin RJ, Benharash P. Trends in Readmission and Costs After Transcatheter Implantation Versus Surgical Aortic Valve Replacement in Patients With Renal Dysfunction. Am J Cardiol 2019; 123:1481-1488. [PMID: 30826049 PMCID: PMC7670473 DOI: 10.1016/j.amjcard.2019.01.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
Abstract
Patients with renal dysfunction are at increased risk for developing aortic valve pathology. In the present era of value-based healthcare delivery, a comparison of transcatheter and surgical aortic valve replacement (SAVR) readmission performance in this population is warranted. All adult patients who underwent transcatheter or SAVR from 2011 to 2014 were identified using the Nationwide Readmissions Database, containing data for nearly 50% of US hospitalizations. Patients were further stratified as chronic kidney disease stage 1 to 5 as well as end-stage renal disease requiring dialysis. Kaplan-Meier, Cox Hazard, and multivariable regression models were generated to identify predictors of readmission and costs. Of the 350,609 isolated aortic valve replacements, 4.7% of patients suffered from chronic kidney disease stages 1 to 5 or end-stage renal disease. Transcatheter aortic valve patients with chronic kidney disease stages 1 to 5/or end-stage renal disease were older (81.9 vs 72.9 years, p <0.0001) with a higher prevalence of heart failure (15.2 vs 4.3%, p = 0.04), and peripheral vascular disease (31.1 vs 22.8%, p <0.0001) compared to their SAVR counterparts. Transcatheter aortic valve replacement in chronic kidney disease stage 1 to 3 patients had a higher rate of readmission due to heart failure and pacemaker placement than SAVR. Transcatheter aortic valve replacement was associated with increased costs compared with SAVR for all renal failure patients. In conclusion, in this national cohort of chronic and end-stage renal disease patients, transcatheter aortic valve implantation was associated with increased mortality, readmissions for chronic kidney disease stages1 to 3, and index hospitalization costs.
Collapse
Affiliation(s)
- Yas Sanaiha
- Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, California
| | - Aditya Mantha
- Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, California; University of California Irvine, School of Medicine, Irvine, California
| | - Boback Ziaeian
- Division of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Yen-Yi Juo
- Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, California
| | - Richard J Shemin
- Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, California
| | - Peyman Benharash
- Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, California.
| |
Collapse
|
18
|
Bavaria JE, Tommaso CL, Brindis RG, Carroll JD, Deeb GM, Feldman TE, Gleason TG, Horlick EM, Kavinsky CJ, Kumbhani DJ, Miller DC, Seals AA, Shahian DM, Shemin RJ, Sundt TM, Thourani VH. 2018 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and institutional recommendations and requirements for transcatheter aortic valve replacement. J Thorac Cardiovasc Surg 2019; 157:e77-e111. [DOI: 10.1016/j.jtcvs.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
19
|
Wagner G, Steiner S, Gartlehner G, Arfsten H, Wildner B, Mayr H, Moertl D. Comparison of transcatheter aortic valve implantation with other approaches to treat aortic valve stenosis: a systematic review and meta-analysis. Syst Rev 2019; 8:44. [PMID: 30722786 PMCID: PMC6362570 DOI: 10.1186/s13643-019-0954-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 01/18/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVI) is an alternative treatment for patients with symptomatic severe aortic stenosis ineligible for surgical aortic valve replacement (SAVR) or at increased perioperative risk. Due to continually emerging evidence, we performed a systematic review and meta-analysis comparing benefits and harms of TAVI, SAVR, medical therapy, and balloon aortic valvuloplasty. METHODS We searched MEDLINE, Embase, and Cochrane CENTRAL from 2002 to June 6, 2017. We dually screened abstracts and full-text articles for randomized controlled trials (RCTs) and propensity score-matched observational studies. Two investigators independently rated the risk of bias of included studies and determined the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). If data permitted, we performed meta-analyses using random- and fixed-effects models. RESULTS Out of 7755 citations, we included six RCTs (5862 patients) and 13 observational studies (6376 patients). In meta-analyses, patients treated with SAVR or TAVI had similar risks for mortality at 30 days (relative risk [RR] 1.05; 95% confidence interval [CI] 0.82 to 1.33) and 1 year (RR 1.02; 95% CI 0.93 to 1.13). TAVI had significantly lower risks for major bleeding but increased risks for major vascular complications, moderate or severe paravalvular aortic regurgitation, and new pacemaker implantation compared to SAVR. Comparing TAVI to medical therapy, mortality did not differ at 30 days but was significantly reduced at 1 year (RR 0.51; 95% CI 0.34 to 0.77). CONCLUSIONS Given similar mortality risks but different patterns of adverse events, the choice between TAVI and SAVR remains an individual one.
Collapse
Affiliation(s)
- Gernot Wagner
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Sabine Steiner
- Division of Interventional Angiology, University Hospital Leipzig, Liebigstraße 20, Haus 4, 04103 Leipzig, Germany
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
- RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Henrike Arfsten
- Department of Medicine II, Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Brigitte Wildner
- University Library-Information Retrieval Office, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Harald Mayr
- Department of Internal Medicine 3, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, Dunant-Platz 1, 3100 St. Poelten, Austria
- Institute for Research of Ischaemic Cardiac Disease and Rhythmology, Karl Landsteiner Society, Dunant-Platz 1, 3100 St. Poelten, Austria
| | - Deddo Moertl
- Department of Internal Medicine 3, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, Dunant-Platz 1, 3100 St. Poelten, Austria
- Institute for Research of Ischaemic Cardiac Disease and Rhythmology, Karl Landsteiner Society, Dunant-Platz 1, 3100 St. Poelten, Austria
| |
Collapse
|
20
|
Schymik G, Bramlage P, Herzberger V, Bergmann J, Conzelmann LO, Würth A, Luik A, Schröfel H, Tzamalis P. Impact of Dialysis on the Prognosis of Patients Undergoing Transcatheter Aortic Valve Implantation. Am J Cardiol 2019; 123:315-322. [PMID: 30424871 DOI: 10.1016/j.amjcard.2018.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 11/28/2022]
Abstract
End-stage renal disease (ESRD) affects approximately 2% to 4% of patients with severe aortic stenosis. It is because these patients have been excluded from clinical trials, the impact of transcatheter aortic valve implantation (TAVI) in this patient group has not been thoroughly investigated. Between April 2008 and March 2015, 2,000 patients (dialysis group, n = 56 [2.8%]) were consecutively enrolled when diagnosed with severe aortic stenosis and eligible to undergo TAVI. Procedural and longer-term outcomes were analyzed and adjusted for differences in baseline characteristics. Patients on dialysis had a higher periprocedural mortality (10.7% vs 1.7%; adjusted odds ratio [adjOR] 5.65, 95% confidence interval [CI] 1.91 to 16.67; p = 0.002) and a lower Valve Academic Research Consortium (VARC)-II (VARC) defined device success (adjOR 0.34, 95% CI 0.15 to 0.79; p = 0.012). At 30 days, there was an increased rate of all-cause mortality (21.4 vs 4.8%; adjOR 4.90, 95% CI 1.96 to 12.26; p = 0.001), cardiovascular (adjOR 3.67, 95% CI 1.43 to 9.41; p = 0.007) and noncardiovascular mortality (adjOR 6.28, 95% CI 1.36 to 9.41; p = 0.019), myocardial infarction (adjOR 9.39, 95% CI 1.84 to 48.03; p = 0.007), bleeding (adjOR 2.48, 95% CI 1.06 to 5.83; p = 0.036) as well as the VARC-II defined early safety combined end point (adjOR 2.97, 95% CI 1.28 to 6.90; p = 0.012) associated with dialysis. Dialysis was associated with poor survival at one (57.1% vs 84.2%) and 3 years (26.8% vs 66.9%) with or without the consideration of the first 72 hours (p <0.001; adjusted p <0.001). Although, in the multivariable regression analysis, reduced ejection fraction, peripheral arterial disease, pulmonary hypertension (PH), frailty and dialysis were associated with 1-year mortality, only PH (>60 mm Hg) remained significant in an analysis restricted to the dialysis patients (adjusted hazard ratio 2.68; 95% CI 1.18 to 5.88; p = 0.018). PH had a sensitivity of 45.8%, a specificity of 81.3%, and a positive predictive value of 64.7%. In conclusion, dialysis is an independent predictor of mortality in patients who underwent TAVI. Long-term mortality in dialysis patients appears to be largely determined by the kidney disease and/or dialysis itself whereas VARC-II defined complications are largely unaffected. An increased short-term mortality still calls for (pre-) procedural optimization.
Collapse
Affiliation(s)
- Gerhard Schymik
- Department of Cardiology, Medical Clinic IV, Municipal Hospital Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Germany.
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Valentin Herzberger
- Department of Cardiology, Medical Clinic IV, Municipal Hospital Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Germany
| | - Jens Bergmann
- Department of Cardiology, Medical Clinic IV, Municipal Hospital Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Germany
| | | | - Alexander Würth
- Department of Cardiology, Medical Clinic III, Vincentius Hospital Karlsruhe, Germany
| | - Armin Luik
- Department of Cardiology, Medical Clinic IV, Municipal Hospital Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Germany
| | - Holger Schröfel
- Department Cardiovascular Surgery, University Heart Center Freiburg, Bad Krozingen, Germany
| | - Panagiotis Tzamalis
- Department of Cardiology, Medical Clinic IV, Municipal Hospital Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Germany
| |
Collapse
|
21
|
Bavaria JE, Tommaso CL, Brindis RG, Carroll JD, Michael Deeb G, Feldman TE, Gleason TG, Horlick EM, Kavinsky CJ, Kumbhani DJ, Craig Miller D, Allen Seals A, Shahian DM, Shemin RJ, Sundt TM, Thourani VH. 2018 AATS/ACC/SCAI/STS expert consensus systems of care document: Operator and institutional recommendations and requirements for transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2019; 93:E153-E184. [DOI: 10.1002/ccd.27811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 06/10/2018] [Indexed: 11/10/2022]
Affiliation(s)
| | - Carl L. Tommaso
- Society for Cardiovascular Angiography and Interventions Representative
| | | | | | | | - Ted E. Feldman
- Society for Cardiovascular Angiography and Interventions Representative
| | | | - Eric M. Horlick
- Society for Cardiovascular Angiography and Interventions Representative
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Bavaria JE, Tommaso CL, Brindis RG, Carroll JD, Deeb GM, Feldman TE, Gleason TG, Horlick EM, Kavinsky CJ, Kumbhani DJ, Miller DC, Seals AA, Shahian DM, Shemin RJ, Sundt TM, Thourani VH. 2018 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2019; 73:340-374. [DOI: 10.1016/j.jacc.2018.07.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
23
|
Pineda AM, Kevin Harrison J, Kleiman NS, Reardon MJ, Conte JV, O'Hair DP, Chetcuti SJ, Huang J, Yakubov SJ, Popma JJ, Beohar N. Clinical impact of baseline chronic kidney disease in patients undergoing transcatheter or surgical aortic valve replacement. Catheter Cardiovasc Interv 2018; 93:740-748. [DOI: 10.1002/ccd.27928] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Andres M. Pineda
- Division of CardiologyUniversity of Florida College of Medicine‐Jacksonville Jacksonville Florida
| | - J. Kevin Harrison
- Department of MedicineDuke University Medical Center Durham North Carolina
| | - Neal S. Kleiman
- Department of CardiologyHouston Methodist DeBakey Heart and Vascular Center Houston Texas
| | - Michael J. Reardon
- Department of Cardiothoracic SurgeryHouston Methodist DeBakey Heart and Vascular Center Houston Texas
| | - John V. Conte
- Division of Cardiac SurgeryJohns Hopkins University Baltimore Maryland
| | - Daniel P. O'Hair
- Department of Cardiothoracic SurgeryAurora Healthcare Milwaukee Wisconsin
| | - Stanley J. Chetcuti
- Department of Internal Medicine, Division of CardiologyUniversity of Michigan Ann Arbor Michigan
| | - Jian Huang
- Coronary and Structural Heart Clinical Department Mounds View Minnesota
| | | | - Jeffrey J. Popma
- Department of Internal Medicine, Cardiovascular DivisionBeth Israel Deaconess Medical Center Boston Massachusetts
| | - Nirat Beohar
- Division of Cardiology at Mount Sinai Medical Center, Columbia University Miami Beach Florida
| |
Collapse
|
24
|
Amione-Guerra J, Mattathil S, Prasad A. A Meta-Analysis of Clinical Outcomes of Transcatheter Aortic Valve Replacement in Patients with End-Stage Renal Disease. STRUCTURAL HEART 2018. [DOI: 10.1080/24748706.2018.1522460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Javier Amione-Guerra
- Department of Medicine, Division of Cardiology, University of Texas Health Science Center at San Antonio , San Antonio, Texas, USA
| | - Stephanie Mattathil
- Department of Medicine, Division of Cardiology, University of Texas Health Science Center at San Antonio , San Antonio, Texas, USA
| | - Anand Prasad
- Department of Medicine, Division of Cardiology, University of Texas Health Science Center at San Antonio , San Antonio, Texas, USA
| |
Collapse
|
25
|
2018 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Aortic Valve Replacement: A Joint Report of the American Association for Thoracic Surgery, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons. Ann Thorac Surg 2018; 107:650-684. [PMID: 30030976 DOI: 10.1016/j.athoracsur.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 11/22/2022]
|
26
|
Takagi H, Mitta S, Ando T. Long-term survival after transcatheter versus surgical aortic valve replacement for aortic stenosis: A meta-analysis of observational comparative studies with a propensity-score analysis. Catheter Cardiovasc Interv 2018; 92:419-430. [DOI: 10.1002/ccd.27521] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/24/2017] [Accepted: 01/08/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery; Shizuoka Medical Center; Shizuoka Japan
| | - Shohei Mitta
- Department of Cardiovascular Surgery; Shizuoka Medical Center; Shizuoka Japan
| | - Tomo Ando
- Department of Cardiology; Detroit Medical Center; Detroit Michigan
| | | |
Collapse
|
27
|
Predictors and Clinical Outcomes of Next-Day Discharge After Minimalist Transfemoral Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2018; 11:107-115. [DOI: 10.1016/j.jcin.2017.10.021] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 10/11/2017] [Accepted: 10/17/2017] [Indexed: 12/12/2022]
|
28
|
Alqahtani F, Aljohani S, Boobes K, Maor E, Sherieh A, Rihal CS, Holmes DR, Alkhouli M. Outcomes of Transcatheter and Surgical Aortic Valve Replacement in Patients on Maintenance Dialysis. Am J Med 2017; 130:1464.e1-1464.e11. [PMID: 28623173 PMCID: PMC5705334 DOI: 10.1016/j.amjmed.2017.05.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 05/02/2017] [Accepted: 05/02/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND The introduction of transcatheter aortic valve replacement (TAVR) expanded definitive therapy of aortic stenosis to many high-risk patients, but it has not been fully evaluated in the dialysis population. We aimed to evaluate the current trend and in-hospital outcome of surgical aortic valve replacement (SAVR) and TAVR in the dialysis population. METHODS Severe aortic stenosis patients on maintenance dialysis who underwent SAVR or TAVR in the Nationwide Inpatient Sample database from January 1, 2005, through December 31, 2014, were included in our comparative analysis. The trends of SAVR and TAVR were assessed. In-hospital mortality, rates of major adverse events, hospital length of stay, cost of care, and intermediate care facility utilization were compared between the 2 groups using both unadjusted and propensity-matched data. RESULTS Utilization of aortic valve replacement in dialysis patients increased 3-fold; a total of 2531 dialysis patients who underwent either SAVR (n = 2264) or TAVR (n = 267) between 2005 and 2014 were identified. Propensity score matching yielded 197 matched pairs. After matching, a 2-fold increase in in-hospital mortality was found with SAVR compared with TAVR (13.7% vs 6.1%, P = .021). Patients who underwent TAVR had more permanent pacemaker implantation (13.2% vs 5.6%, P = .012) but less blood transfusion (43.7% vs 56.8%, P = .02). Rates of other key morbidities were similar. Hospital length of stay (19 ± 16 vs 11 ± 11 days, P <.001) and non-home discharges (44.7% vs 31.5%, P = .002) were significantly higher with SAVR. Cost of hospitalization was 25% less with TAVR. CONCLUSION In patients on maintenance dialysis, TAVR is associated with lower hospital mortality, resource utilization, and cost in comparison with SAVR.
Collapse
Affiliation(s)
- Fahad Alqahtani
- West Virginia University Heart & Vascular Institute, Morgantown
| | - Sami Aljohani
- West Virginia University Heart & Vascular Institute, Morgantown
| | - Khaled Boobes
- Division of Nephrology, Department of Medicine, Northwestern University, Chicago, Ill
| | - Elad Maor
- Department of Cardiology, Mayo Clinic, Rochester, Minn
| | - Assem Sherieh
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor
| | | | | | - Mohamad Alkhouli
- West Virginia University Heart & Vascular Institute, Morgantown; Department of Cardiology, Mayo Clinic, Rochester, Minn.
| |
Collapse
|
29
|
Alkhalil A, Golbari S, Song D, Lamba H, Fares A, Alaiti A, Deo S, Attizzani GF, Ibrahim H, Ruiz CE. In-hospital outcomes of transcatheter versus surgical aortic valve replacement in end stage renal disease. Catheter Cardiovasc Interv 2017; 92:757-765. [DOI: 10.1002/ccd.27433] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 08/30/2017] [Accepted: 10/31/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Ahmad Alkhalil
- Department of Medicine/Division of Cardiology; Rutgers University School of Medicine; Newark New Jersey
| | - Shervin Golbari
- Department of Medicine/Division of Cardiology; Rutgers University School of Medicine; Newark New Jersey
| | - David Song
- Department of Medicine/Division of Cardiology; Rutgers University School of Medicine; Newark New Jersey
| | - Harveen Lamba
- Department of Medicine/Division of Cardiology; Case Western Reserve University; Cleveland Ohio
| | - Anas Fares
- Department of Medicine/Division of Cardiology; Case Western Reserve University; Cleveland Ohio
| | - Amer Alaiti
- Department of Medicine/Division of Cardiology; Case Western Reserve University; Cleveland Ohio
| | - Salil Deo
- Department of Medicine/Division of Cardiology; Case Western Reserve University; Cleveland Ohio
| | - Guilherme F. Attizzani
- Department of Medicine/Division of Cardiology; Case Western Reserve University; Cleveland Ohio
| | - Homam Ibrahim
- Department of Medicine/Division of Cardiology; University of Utah; Salt Lake City Utah
| | - Carlos E. Ruiz
- Department of Medicine/Division of Cardiology; Hackensack University Medical Center; Hackensack New Jersey
| |
Collapse
|
30
|
Does diabetes mellitus impact prognosis after transcatheter aortic valve implantation? Insights from a meta-analysis. J Cardiol 2017; 70:484-490. [DOI: 10.1016/j.jjcc.2017.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/15/2017] [Accepted: 01/28/2017] [Indexed: 01/13/2023]
|
31
|
Aljohani S, Alqahtani F, Almustafa A, Boobes K, Modi S, Alkhouli M. Trends and Outcomes of Aortic Valve Replacement in Patients With End-Stage Renal Disease on Hemodialysis. Am J Cardiol 2017; 120:1626-1632. [PMID: 28882333 DOI: 10.1016/j.amjcard.2017.07.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/30/2017] [Accepted: 07/10/2017] [Indexed: 11/29/2022]
Abstract
Hemodialysis (HD) patients with aortic stenosis are less likely to undergo aortic valve replacement (AVR) due to their excess perioperative mortality. We aimed to evaluate contemporary utilization and outcomes of combined and isolated AVR in HD patients. The Nationwide Inpatient Sample was used to identify 142,046 patients who underwent AVR in 2005 to 2014, of whom 2,264 (1.6%) were on HD. Crude and adjusted in-hospital outcomes and costs were assessed in unmatched and propensity-matched cohorts of HD and non-HD patients, respectively. The utilization of AVR in HD patients increased significantly (p = 0.047), with a significant decrease in mortality (p = 0.013). Compared with patients not on HD, crude in-hospital mortality in HD patients was twice higher (11.8% vs 6.2%, p <0.0001). HD patients had more blood transfusion and a trend toward more strokes. Lengths of stay and hospital charges, and rates of nonhome discharges were also higher in the HD group. In the propensity-matched cohorts of HD versus non-HD patients, in-hospital mortality rates after AVR remained twofold higher in the HD group (8.1% vs 3.9%, p <0.001). Rates of blood transfusion, cardiac tamponade, length of stay, hospital charges, and nonhome discharges were also higher in HD patients. In conclusion, AVR utilization in HD patients increased and its associated mortality decreased over the last decade. However, AVR mortality in HD patients remained twofold higher compared with non-HD patients. Also, AVR in HD patients was associated with higher cost, longer hospitalizations, and more frequent nonhome discharges.
Collapse
Affiliation(s)
- Sami Aljohani
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Fahad Alqahtani
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Ahmad Almustafa
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Khaled Boobes
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sujal Modi
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Mohamad Alkhouli
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia.
| |
Collapse
|
32
|
Franzone A, Stortecky S, Pilgrim T, Asami M, Lanz J, Heg D, Langhammer B, Piccolo R, Lee JKT, Praz F, Räber L, Valgimigli M, Roost E, Windecker S. Incidence and impact of renal dysfunction on clinical outcomes after transcatheter aortic valve implantation. Int J Cardiol 2017; 250:73-79. [PMID: 28993000 DOI: 10.1016/j.ijcard.2017.09.201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/31/2017] [Accepted: 09/25/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND The impact of baseline renal dysfunction on early and late clinical outcomes after transcatheter aortic valve implantation (TAVI) remains to be defined. METHODS 927 patients included in the prospective Bern TAVI registry were classified on the basis of the baseline estimated glomerular filtration rate (eGFR), as having none or mild (eGFR ≥60mL/min/1.73m2, n=284, 30.6%), moderate (eGFR between 30 and 59mL/min/1.73m2, n=535, 57.7%) and severe (eGFR <30mL/min/1.73m2, n=108, 11.7%) renal dysfunction. RESULTS A graded relationship between stages of renal dysfunction and increasing risk profile was observed with higher STS score and lower left ventricular ejection fraction among patients with eGFR<30 (p<0.001 across groups). In patients with none or mild, moderate, and severe renal dysfunction the rate of all-cause mortality was 1.8%, 5.2% and 8.3% at 30-day and 11.0%, 15.0% and 19.5% at 1-year, respectively. After adjusting for relevant confounders, severe renal dysfunction was associated with an increased risk of cardiovascular death (adjusted Hazard Ratio, HRadj, 3.90, 95% Confidence Interval, CI 1.15-13.2) and stage 3 acute kidney injury (HRadj 5.15, 95% CI 1.72-15.5) at 30-day follow-up, however no significant association was found for clinical outcomes at 1-year follow-up. Moreover, moderate and severe renal dysfunction were found to be associated with bleeding at 1-year follow-up (HRadj, 1.36, 95% CI 1.04-1.78 and HRadj 1.49, 95% CI 1.00-2.21, respectively). CONCLUSIONS Pre-procedural renal dysfunction differentially affects early clinical outcomes, although the magnitude of this association is diluted over time by the overriding effect of underlying risk and comorbidities.
Collapse
Affiliation(s)
- Anna Franzone
- Department of Cardiology, University of Bern, Switzerland
| | | | - Thomas Pilgrim
- Department of Cardiology, University of Bern, Switzerland
| | - Masahiko Asami
- Department of Cardiology, University of Bern, Switzerland
| | - Jonas Lanz
- Department of Cardiology, University of Bern, Switzerland
| | - Dik Heg
- Clinical Trials Unit Bern, University of Bern, Switzerland
| | | | | | - Joe K T Lee
- Department of Cardiology, University of Bern, Switzerland
| | - Fabien Praz
- Department of Cardiology, University of Bern, Switzerland
| | - Lorenz Räber
- Department of Cardiology, University of Bern, Switzerland
| | | | - Eva Roost
- Department of Cardiovascular Surgery, University of Bern, Switzerland
| | | |
Collapse
|
33
|
Gupta T, Goel K, Kolte D, Khera S, Villablanca PA, Aronow WS, Bortnick AE, Slovut DP, Taub CC, Kizer JR, Pyo RT, Abbott JD, Fonarow GC, Rihal CS, Garcia MJ, Bhatt DL. Association of Chronic Kidney Disease With In-Hospital Outcomes of Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2017; 10:2050-2060. [PMID: 29050621 DOI: 10.1016/j.jcin.2017.07.044] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/21/2017] [Accepted: 07/19/2017] [Indexed: 11/15/2022]
|
34
|
Thourani VH, Borger MA, Holmes D, Maniar H, Pinto F, Miller C, Rodés-Cabau J, Mohr FW, Schröfel H, Moat NE, Beyersdorf F, Patterson GA, Weisel R. Transatlantic Editorial on Transcatheter Aortic Valve Replacement. Ann Thorac Surg 2017. [DOI: 10.1016/j.athoracsur.2017.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
35
|
Thourani VH, Borger MA, Holmes D, Maniar H, Pinto F, Miller C, Rodés-Cabau J, Mohr FW, Schröfel H, Moat NE, Beyersdorf F, Patterson AG, Weisel R. Transatlantic Editorial on transcatheter aortic valve replacement. Eur J Cardiothorac Surg 2017; 52:1-13. [PMID: 28874024 DOI: 10.1093/ejcts/ezx196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/11/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Vinod H Thourani
- Division of Cardiothoracic Surgery, Joseph B. Whitehead Department of Surgery, Emory University, Atlanta, GA, USA
| | - Michael A Borger
- Division of Cardiac Surgery, Department of Surgery, Columbia University, New York, NY, USA
| | - David Holmes
- Department of Cardiology, Mayo Clinic, Rochester, MN, USA
| | - Hersh Maniar
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University, St Louis, MO, USA
| | - Fausto Pinto
- Department of Cardiology, University Hospital Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Craig Miller
- Department of Cardiac Surgery, Stanford University, Palo Alto, CA, USA
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
| | | | | | - Neil E Moat
- Cardiovascular Biomedical Research Unit, National Institute Health Research, Royal Brompton Hospital and Harefield National Health Service Foundation Trust, London, UK
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Heart Centre Freiburg University, Freiburg, Germany
| | - Alec G Patterson
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Richard Weisel
- Division of Cardiovascular Surgery, Peter Munk Cardiovascular Center, Toronto General Research Institute, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
36
|
Thourani VH, Borger MA, Holmes D, Maniar H, Pinto F, Miller C, Rodés-Cabau J, Mohr FW, Schröfel H, Moat NE, Beyersdorf F, Patterson GA, Weisel R. Transatlantic editorial on transcatheter aortic valve replacement. J Thorac Cardiovasc Surg 2017. [DOI: 10.1016/j.jtcvs.2017.03.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
37
|
O’Hair DP, Bajwa TK, Chetcuti SJ, Deeb GM, Stoler RC, Hebeler RF, Maini B, Mumtaz M, Kleiman NS, Reardon MJ, Li S, Adams DH, Watson DR, Yakubov SJ, Popma JJ, Petrossian G. One-Year Outcomes of Transcatheter Aortic Valve Replacement in Patients With End-Stage Renal Disease. Ann Thorac Surg 2017; 103:1392-1398. [DOI: 10.1016/j.athoracsur.2016.11.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/29/2016] [Accepted: 11/21/2016] [Indexed: 11/28/2022]
|
38
|
Leontyev S, Davierwala PM, Gaube LM, Röhrig KA, Lehmann S, Holzhey DM, Seeburger J, Noack T, Misfeld M, Mohr FW. Outcomes of Dialysis-Dependent Patients After Cardiac Operations in a Single-Center Experience of 483 Patients. Ann Thorac Surg 2017; 103:1270-1276. [DOI: 10.1016/j.athoracsur.2016.07.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/22/2016] [Accepted: 07/20/2016] [Indexed: 11/16/2022]
|
39
|
Thongprayoon C, Cheungpasitporn W, Kittanamongkolchai W, Srivali N, Greason KL, Kashani K. Changes in kidney function among patients undergoing transcatheter aortic valve replacement. J Renal Inj Prev 2017. [DOI: 10.15171/jrip.2017.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|
40
|
Takagi H, Ando T, Umemoto T. Direct and adjusted indirect comparisons of perioperative mortality after sutureless or rapid-deployment aortic valve replacement versus transcatheter aortic valve implantation. Int J Cardiol 2017; 228:327-334. [PMID: 27866023 DOI: 10.1016/j.ijcard.2016.11.253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To determine which procedure, aortic valve replacement (AVR) with a sutureless or rapid-deployment prosthesis (SL-AVR) or transcatheter aortic valve implantation (TAVI), achieves better perioperative survival for severe aortic stenosis (AS), we conducted direct-comparison meta-analyses (DC-MAs) and an adjusted indirect-comparison meta-analysis (IDC-MA). METHODS We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials through April 2016. Eligible studies were randomized controlled trials (RCTs) and propensity-score matched (PSM) studies. We performed a DC-MA-[A] of SL-AVR versus TAVI, a DC-MA-[B] of SL-AVR versus conventional AVR (C-AVR), and a DC-MA-[C] TAVI versus C-AVR. Then, we computed a IDC-MA-[A'] of TAVI versus SL-AVR from the results of the DC-MA-[B] and the DC-MA-[C]. RESULTS We identified 6 RCTs and 30 PSM studies enrolling a total of 15,887 patients. The 3 DC-MAs demonstrated significantly lower perioperative (30-day or in-hospital) all-cause mortality after SL-AVR than after TAVI (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.28 to 0.80; p=0.005) and no significant differences between SL-AVR and C-AVR (OR, 1.07; 95% CI, 0.60 to 1.94; p=0.81) and between TAVI and C-AVR (1.07; 95% CI, 0.90 to 1.27; p=0.45). The computed IDC-MA-[A'] indicated no significant difference in mortality between SL-AVR and TAVI (1.01; 95% CI, 0.54 to 1.86). Combining the results of the DC-MA-[A] and IDC-MA [A'] showed significantly lower mortality after SL-AVR than after TAVI (OR, 0.65; 95% CI, 0.44 to 0.97; p=0.03). CONCLUSIONS For patients with severe AS, SL-AVR may achieve better perioperative survival than TAVI.
Collapse
Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
| | - Tomo Ando
- Department of Cardiology, Detroit Medical Center, Detroit, MI, United States
| | - Takuya Umemoto
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
| | | |
Collapse
|
41
|
Villablanca PA, Mathew V, Thourani VH, Rodés-Cabau J, Bangalore S, Makkiya M, Vlismas P, Briceno DF, Slovut DP, Taub CC, McCarthy PM, Augoustides JG, Ramakrishna H. A meta-analysis and meta-regression of long-term outcomes of transcatheter versus surgical aortic valve replacement for severe aortic stenosis. Int J Cardiol 2016; 225:234-243. [DOI: 10.1016/j.ijcard.2016.10.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/04/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
|
42
|
Takagi H, Umemoto T. Worse survival after transcatheter aortic valve implantation than surgical aortic valve replacement: A meta-analysis of observational studies with a propensity-score analysis. Int J Cardiol 2016; 220:320-7. [DOI: 10.1016/j.ijcard.2016.06.261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/15/2016] [Accepted: 06/27/2016] [Indexed: 12/24/2022]
|
43
|
Cheungpasitporn W, Thongprayoon C, Kashani K. Transcatheter Aortic Valve Replacement: a Kidney's Perspective. J Renal Inj Prev 2016; 5:1-7. [PMID: 27069960 PMCID: PMC4827378 DOI: 10.15171/jrip.2016.01] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 01/05/2016] [Indexed: 12/24/2022] Open
Abstract
Transcatheter aortic valve replacement (TAVR) has now emerged as a viable treatment option for high-risk patients with severe aortic stenosis (AS) who are not suitable candidates for surgical aortic valve replacement (SAVR). Despite encouraging published outcomes, acute kidney injury (AKI) is common and lowers the survival of patients after TAVR. The pathogenesis of AKI after TAVR is multifactorial including TAVR specific factors such as the use of contrast agents, hypotension during rapid pacing, and embolization; preventive measures may include pre-procedural hydration, limitation of contrast dye exposure, and avoidance of intraprocedural hypotension. In recent years, the number of TAVR performed worldwide has been increasing, as well as published data on renal perspectives of TAVR including AKI, chronic kidney disease, end-stage kidney disease, and kidney transplantation. This review aims to present the current literature on the nephrology aspects of TAVR, ultimately to improve the patients' quality of care and outcomes.
Collapse
Affiliation(s)
- Wisit Cheungpasitporn
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Charat Thongprayoon
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA
| | - Kianoush Kashani
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|