AKI after Transcatheter or Surgical Aortic Valve Replacement
Why the study?
Does transcatheter aortic valve replacement reduce postoperative acute kidney injury and major adverse kidney events compared to surgical aortic valve replacement in high-risk patients with severe aortic stenosis?
Population
390 adult patients undergoing isolated aortic valve replacement for symptomatic severe aortic stenosis at…
Comparison
Transcatheter aortic valve replacement (TAVR) vs Surgical aortic valve replacement (SAVR)
Design
Cohort
Follow-up
>6 months
Authors
Discussion
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Member takes
Implication
Similar AKI rates after TAVR or SAVR support equivalence hypothesis; leaves open need for randomized confirmation in high-risk aortic stenosis.
Structured PICO
Does transcatheter aortic valve replacement reduce postoperative acute kidney injury and major adverse kidney events compared to surgical aortic valve replacement in high-risk patients with severe aortic stenosis?
P
Population
390 adult patients (195 propensity-matched pairs from 1563 eligible) undergoing isolated aortic valve replacement for symptomatic severe aortic stenosis at high risk of perioperative mortality at a single center in the United States.
I
Intervention
Transcatheter aortic valve replacement (TAVR)
C
Comparator
Surgical aortic valve replacement (SAVR)
O
Outcome
Postoperative incidence of acute kidney injury (AKI) defined by KDIGO guidelines, and major adverse kidney events (composite of in-hospital mortality, use of renal replacement therapy, and persistent elevated serum creatinine ≥200% from baseline at hospital discharge)safety
In a propensity-matched cohort of high-risk patients with severe aortic stenosis, TAVR and SAVR had similar rates of postoperative acute kidney injury and major adverse kidney events.
Cite This Study
Thongprayoon et al. (2015) studied this question.