Transapical versus transfemoral approach and risk of acute kidney injury following transcatheter aortic valve replacement: a propensity-adjusted analysis
Key result
Transapical TAVR significantly increased the risk of acute kidney injury compared with a transfemoral approach (38% vs. 18%, p < 0.01; matched OR 3.82, 95% CI 2.04-7.44).
Why the study?
Does a transapical approach increase the risk of acute kidney injury compared to a transfemoral approach in patients undergoing TAVR for aortic stenosis?
Population
366 consecutive adult patients undergoing transcatheter aortic valve replacement for aortic stenosis at a…
Comparison
Transapical (TA) approach for TAVR (n=171) vs Transfemoral (TF) approach for TAVR (n=195)
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
Transapical TAVR was associated with higher AKI risk; hypothesis-generating and should not yet change practice pending randomized data.
Study Design
Type
Cohort (n=366)
Multicenter
No
Structured PICO
Does a transapical approach increase the risk of acute kidney injury compared to a transfemoral approach in patients undergoing TAVR for aortic stenosis?
P
Population
366 consecutive adult patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis at a tertiary referral hospital
I
Intervention
Transapical (TA) approach for TAVR (n=171)
C
Comparator
Transfemoral (TF) approach for TAVR (n=195)
O
Outcome
Incidence of post-procedural acute kidney injury (AKI) based on KDIGO criteriasafety
Main Result
Effect estimate: OR 3.82 (95% CI 2.04-7.44)
Absolute Event Rate: 38% vs 18%
p-value: p=< .01
The transapical approach for TAVR is associated with a significantly higher risk of acute kidney injury compared to the transfemoral approach, although it does not appear to affect long-term renal function at 6 months.
Cite This Study
Thongprayoon et al. (2016) conducted a cohort in aortic stenosis (n=366). Transapical (TA) approach vs. Transfemoral (TF) approach was evaluated on post-procedural acute kidney injury (AKI) (OR 3.82, 95% CI 2.04-7.44, p=< .01). Transapical TAVR significantly increased the risk of acute kidney injury compared with a transfemoral approach (38% vs. 18%, p < 0.01; matched OR 3.82, 95% CI 2.04-7.44).