25 Sep Impact of Renal Dysfunction on Results of TAVR Outcomes
MedicalResearch.com Interview with:
Pablo Codner, MD; Amos Levi, MD (firsts authors)
and Prof. Ran Kornowski, MD, FACC, FESC (senior author)
Rabin Medical Center Derech Ze`ev
Israel.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe aortic stenosis (AS) who are deemed inoperable by the “heart team”, for those at high risk for surgery and also for patients at intermediate surgical risk. Currently this therapeutic alternative is being compared with surgical aortic valve replacement in patients at low risk for surgery. Patients with chronic kidney disease were excluded from most randomized trials.
We evaluated outcomes within a large multicenter cohort of patients undergoing TAVR distinguished by renal function, from 11 high volume centers in 8 different countries across Europe and Asia. In our experience patients with renal dysfunction were associated with poor clinical outcomes. All-cause and cardiovascular mortality rates during the follow-up period increased with declining renal function. A glomerular filtration rate ≤30 mL/min was identified on multivariate analysis as an independent predictor for all-cause and cardiovascular mortality.
We also found higher rates of severe bleeding and vascular complications among patient with advanced or end stage renal failure.
MedicalResearch.com: What should readers take away from your report?
Response: The study emphasizes in general the need for a comprehensive and individualized risk stratification process in patients with severe AS before a therapeutic strategy is determined, and in particular for those with the frequent association of AS and chronic kidney disease. This is of particular relevance as TAVR treatment switch from being performed in high risk patients with multiple comorbidities to a relatively healthier population of patients at intermediate or low risk for surgical aortic valve replacement.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should focus on the outcomes of TAVR patients treated with new generation devices, renal protection strategies, low profile delivery systems.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our study is also a great example on how international and multicenter collaboration can enhance and promote research opportunities and provide an ideal environment for knowledge interchange.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Impact of Renal Dysfunction on Results of Transcatheter Aortic Valve Replacement Outcomes in a Large Multicenter Cohort
Codner, Pablo et al.
American Journal of Cardiology , Volume 0 , Issue 0 , September 15, 2016
DOI: http://dx.doi.org/10.1016/j.amjcard.2016.08.082
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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Last Updated on September 25, 2016 by Marie Benz MD FAAD