Transcatheter aortic valve implantation in dialysis patients resulted in no 30-day mortality and similar 6-month survival compared to non-dialysis CKD patients (log-rank p=0.935).
Observational (n=155)
Is TAVI safe and effective in patients on chronic hemodialysis compared to non-dialysis CKD patients and compared to open surgical valve replacement?
TAVI appears to be a safe procedure for patients on chronic hemodialysis, offering an alternative to open surgery with comparable short-term survival to non-dialysis CKD patients.
p-value: p=0.935
BACKGROUND/AIMS: Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option for high-risk patients. However, dialysis patients were excluded from all previous studies. The aim of this study is to compare the outcomes of TAVI for dialysis patients with those for patients with chronic kidney disease (CKD) stages 3 and 4 and to compare TAVI with open surgery in dialysis patients. METHODS: Part I: comparison of 10 patients on chronic hemodialysis with 116 patients with non-dialysis-dependent CKD undergoing TAVI. Part II: comparison of transcatheter (n = 15) with open surgical (n = 24) aortic valve replacement in dialysis patients. RESULTS: Part I: dialysis patients were significantly younger (72.3 vs. 82.0 years; p < 0.01). Hospital stay was significantly longer in dialysis patients (21.8 vs. 12.1 days; p = 0.01). Overall 30-day mortality was 3.17%, with no deaths among dialysis patients. Six-month survival rates were similar (log-rank p = 0.935). Part II: patient age was comparable (66.5 vs. 69.5 years; p = 0.42). Patients in the surgical group tended to stay longer in hospital than TAVI patients (29.5 vs. 22.5 days; p = 0.35). CONCLUSION: TAVI is a safe procedure in patients on chronic hemodialysis. Until new data become available, we find no compelling reason to refuse these patients TAVI.
Rau et al. (2012) conducted an observational in Aortic valve disease in dialysis and chronic kidney disease patients (n=155). Transcatheter Aortic Valve Implantation (TAVI) vs. Open surgical aortic valve replacement and non-dialysis CKD patients was evaluated on 6-month survival (p=0.935). Transcatheter aortic valve implantation in dialysis patients resulted in no 30-day mortality and similar 6-month survival compared to non-dialysis CKD patients (log-rank p=0.935).