Death and Dialysis After Transcatheter Aortic Valve Replacement: An Analysis of the STS/ACC TVT Registry
Hansen JW, Foy A, Yadav P, Gilchrist IC, Kozak M, Stebbins A, Matsouaka R, Vemulapalli S, Wang A, Wang DD, Eng MH, Greenbaum AB, O'Neill WO. Death and dialysis after transcatheter aortic valve replacement: An analysis of the sts/acc tvt registry. JACC Cardiovasc Interv. Oct 23 2017;10(20):2064-2075.
JACC Cardiovasc Interv
OBJECTIVES: The authors sought to elucidate the true incidence of renal replacement therapy (RRT) after transcatheter aortic valve replacement (TAVR).
BACKGROUND: There is a wide discrepancy in the reported rate of RRT after TAVR (1.4% to 40%). The true incidence of RRT after TAVR is unknown.
METHODS: The STS/ACC TVT (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy) registry was linked to the Centers for Medicare & Medicaid database to identify all patients that underwent TAVR from November 2011 through September 2015 and their outcomes. The authors compared rates of death, new RRT, and a composite of both as a function of pre-procedure glomerular filtration rate (GFR), both in stages of chronic kidney disease (CKD), as well as on a continuous scale.
RESULTS: Pre-procedure GFR is associated with the risk of death and new RRT after TAVR when GFR is/min/m
CONCLUSIONS: In both unadjusted and adjusted analysis, pre-procedural GFR was associated with the outcomes of death and new RRT. Increasing CKD stage leads to an increased risk of death and/or RRT. Continuous analysis showed significant differences in outcomes in all levels of CKD when GFR was/min/m
Medical Subject Headings
Aged; Aged, 80 and over; Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; Comorbidity; Disease Progression; Female; Glomerular Filtration Rate; Humans; Kidney; Male; Registries; Renal Dialysis; Renal Insufficiency, Chronic; Retrospective Studies; Risk Factors; Time Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome; United States