SAFETY OF ISOLATED TRANSCATHETER TRICUSPID VALVE REPLACEMENT OR REPAIR COMPARED TO SURGERY IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

J Am Coll Cardiol

Keywords

hypertensive factor, acute kidney failure, artificial heart pacemaker, artificial ventilation, bleeding, cardiogenic shock, Caucasian, chronic kidney failure, complication, conference abstract, controlled study, drug combination, female, heart valve replacement, human, intraaortic balloon pump, male, mortality, prospective study, surgery, tricuspid valve replacement, ventricular assist device

Abstract

Background There is limited data on the safety of isolated transcatheter tricuspid valve replacement (TTVR) or repair (TTVr) compared to isolated surgical valve replacement (STVR) or repair (STVr) in patients with chronic kidney disease (CKD). We aimed to study complications of TTVR/TTVr in patients with CKD Methods We identified patients who underwent STVR/STVr and TTVR/TTVr between 2018-2021 using the National Inpatient Sample Database. Those <18 yo or had concomitant valvular procedures were excluded. In-hospital complications include mortality, acute kidney injury (AKI), bleeding, vasopressor use, cardiogenic shock, mechanical ventilation (MV), intra-aortic balloon pump (IABP) or Impella or permanent pacemaker (PPM) insertion. Multivariate logistic regression analyses were performed Results There were 555 (21%) patients who underwent TTVR/TTVr and 2115 (79%) who underwent STVR/STVr. Mean age 60 (±18) yr, and there were 1285 (48%) women, 1705 (64%) were White. TTVR/TTVr was associated with significantly lower odds of death aOR: 0.14; 95% CI (0.04-0.53);p=0.003, AKI aOR: 0.26 (0.15-0.44);<.0001, bleeding aOR: 0.09 (0.05-0.17);<.0001, vasopressor use aOR: 0.24; (0.110.54); 0.0006, MV aOR: 0.06 (0.01-0.21);<.0001, cardiogenic shock aOR: 0.12 (0.05-0.28); <.0001, Impella or IABP aOR: 0.06 (0.01-0.51); 0.009, PPM aOR: 0.21; (0.07-0.65); 0.006 FIGURE Conclusion TTVR/TTVr is safer in patients with CKD compared to surgerical interventions. Further prospective studies are needed [Formula presented]

Volume

85

Issue

12

First Page

955

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