E-17 | Acute Kidney Injury After Transcatheter Aortic Valve Replacement: A Bad Omen?

Transcatheter aortic valve replacement (TAVR) has become the default strategy for most patients with severe symptomatic aortic stenosis. However, procedural complications still have a detrimental impact on short and long-term outcomes in a significant proportion of patients. We aimed to assess the impact of acute kidney injury (AKI) on the in-hospital outcomes of TAVR patients. Data was collected for quality assurance on all patients that underwent TAVR between 2021-2022 at 4 New York metropolitan area hospitals. Data on all patients was entered into the STS ACC TAVR registry. AKI post-procedure was defined as per the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Bleeding was classified according to the Valve Academic Research Consortium (VARC-3). A total of 1,796 patients underwent TAVR between 2021 to 2022, 418 developed AKI and 1,378 did not. There were significant baseline clinical differences between the two groups with more comorbid conditions in the former (Table). VARC Type 1 and 3 bleeding complications were more frequent in AKI patients with significantly higher in-hospital mortality rates and post TAVR permanent pacemaker implantations. Vascular complications and stroke rates were similar in both groups. In patients undergoing TAVR, AKI following the procedure was associated with a significant increase in bleeding complications, pacemaker implantations and in-hospital mortality rates. However, whether AKI is a marker of a sicker population or a prognosticator of poor outcomes remains to be determined. A multivariate analysis will be provided.