Predictors of in-hospital complications after transcatheter aortic valve implantation in patients with degenerative aortic valve disease

Objective. To study the incidence and identify predictors of in-hospital complications associated with transcatheter aortic valve implantation (TAVI) in patients with degenerative aortic valve disease. Material and methods. The study included patients with degenerative aortic valve disease who had indications for TAVI. In-hospital complications were cardiac death, intraoperative myocardial infarction (iMI), stroke and transient ischemic attack (TIA), recurrent paroxysmal atrial fibrillation (rPAF), implantation of a permanent pacemaker (PPM), acute kidney injury (AKI) and cumulative in-hospital morbidity (with the first occurrence considered). Results. The study involved 45 women and 15 men aged 76 (73—80) years with mean EuroScore II 4.8%. Previous myocardial infarction was observed in 18.3% of patients, coronary stenting — 40%, arterial hypertension — 98.3%, type 2 diabetes mellitus — 23.3%, chronic kidney disease (CKD) — 46.7% (stage 3a — 25%, 3b — 20%, IV — 1.7%), chronic heart failure class II — 55%, class III — 45% of patients. There were 5% of iMI, 3.3% of strokes and TIA, 6.6% of PPM implantation, 10% of AKI, 3.3% of rPAF and 3.3% of cardiac deaths due to iMI. Cumulative rate of in-hospital complications was 18.3%. In-hospital complications after TAVI were associated with baseline serum creatinine (p=0.025), urea (p=0.025), GFR (p=0.010), GFR <45 ml/min/1.73 m2 (p=0.034), serum creatinine after intervention >115 µmol/l (p=0.013), more severe stages of AKI (p=0.003). A predictor of TAVI-related in-hospital complications was baseline CKD stage 3b or higher (odds ratio 6.7; 95% confidence interval 1.2—36.6). Conclusion. Cumulative rate of in-hospital complications after TAVI in patients with degenerative aortic valve disease and mean EuroScore II 4.8% was 18.3%. A predictor of TAVI-related in-hospital complications was previous CKD stage 3b or higher.