TY  - JOUR
T1  - Importance of Femoral Access Method in Predicting the Development of Contrast Induced Nephropathy after Transfemoral Transcatheter Aortic Valve Implantation
TT  - Transfemoral Transkateter Aort Valv İmplantasyonu Sonrası Kontrast Bağımlı Nefropati Gelişiminde Femoral Giriş Yönteminin Önemi
AU  - Gül, İlker
AU  - Zungur, Mustafa
AU  - Taştan, Ahmet
AU  - Çekin, Muhammed Esad
AU  - Aykan, Ahmet Çağrı
AU  - İslamlı, Aysel
AU  - Tavlı, Talat
PY  - 2016
DA  - August
JF  - Koşuyolu Heart Journal
PB  - Kartal Koşuyolu Yüksek İhtisas EAH
WT  - DergiPark
SN  - 2149-2972
SP  - 76
EP  - 84
VL  - 19
IS  - 2
LA  - en
AB  - Introduction:Transcatheter aortic valve implantation (TAVI) ismore reliable than surgical valve replacement for high-risk or inoperableaortic stenosis patients. In this study, we aimed to investigate the effects ofdifferent femoral access methods on the development of vascular complicationsand contrast-induced nephropathy (CIN) after transfemoral (TF)-TAVI.Patientsand Methods: In total, 110 patients (aged 78.9 ± 12.2years; 55 females) who underwent aortic valve replacement by TF-TAVI betweenJune 2013 and April 2015 were included in the study. CIN was defined as anabsolute increase in serum creatinine level of > 0.5 mg/dL or a relativeincrease of > 25% within 48-72 h after TF-TAVI. The patients were classifiedinto two groups according to the femoral access methods: surgical cut-down(SCD) and vascular closure device (VCD) groups.Results:The amount of contrast medium (CM; p< 0.001) andthe incidence of CIN (p= 0.038) were higher in the VCD group. Baselineglomerular filtration rate (GFR), baseline creatinine, Mehran score and CM weredetermined as the predictive factors of CIN development. Receiver operatingcharacteristic analysis revealed that CM, which may predict the development ofCIN, was determined as 178.5 mL, and GFR, which may predict the development ofCIN, was determined as 48.9 mL/dk/1.73 m2.Conclusion:It may be preferred to perform the femoral arterialprocedure using the SCD method instead of VCD in TAVI patients whose GFR is< 48.9; the use of CM may increase due to various reasons.
KW  - Contrast induced nephropathy
KW  - transcatheter aortic valve implantation
KW  - femoral artery
KW  - vascular closure device
KW  - surgical cut-down
N2  - Giriş:Transkateter aort valv implantasyonu (TAVİ) yöntemicerrahi kapak replasmanı açısından yüksek riskli veya opere edilemeyen ileriaort darlığı hastalarında daha güvenilir bir yöntemdir. Biz bu çalışmadatransfemoral (TF)-TAVİ sonrası farklı femoral giriş metodlarının, vaskülerkomplikasyonlar ve kontrast bağımlı nefropati (KBN) gelişimi üzerine olanetkilerini araştırmayı amaçladık.Hastalarve Yöntem: Haziran 2013-Nisan 2015tarihleri arasında TAVİ yöntemiyle aort valv replasmanı yapılan 110 hasta (yaş=78.9 ± 12.2 yıl, 55 kadın) çalışmaya dahil edildi. KBN, TF-TAVİ’den 48-72 saatsonra serum kreatinin değerinde > 0.5 mg/dL artış veya başlangıca göre%25’ten daha fazla yükselme olarak tanımlandı. Hastalar vasküler girişyöntemlerine göre cerrahi cut-down (SCD) ve vasküler kapama cihazı (VCD) olarakiki gruba ayırıldı.Bulgular:Kontrast madde (KM) miktarı (p< 0.001) ve KBNinsidansı (p= 0.038) VCD grubunda fazlaydı. Bazal glomerüler filtrasyon oranı(GFO), bazal kreatinin, Mehran skoru ve KM’nin, KBN gelişiminin belirleyicilerioldukları saptandı. ROC analizleri sonucunda; KBN gelişimini belirleyici KMdeğerinin 178.5 mL ve GFO’nun 48.9 mL/dakika/1.73 m2 olduğubelirlendi.Sonuç:Çeşitli nedenlerle kullanılacak KM miktarıartabilecek, GFO 48.9’un altında olan TAVİ hastalarında femoral arteriyelprosedürler için VCD yerine SCD yöntemi tercih edilebilir.
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UR  - https://dergipark.org.tr/en/pub/khj/article/499414
L1  - https://dergipark.org.tr/en/download/article-file/600991
ER  -