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Transfemoral Transkateter Aort Valv İmplantasyonu Sonrası Kontrast Bağımlı Nefropati Gelişiminde Femoral Giriş Yönteminin Önemi

Year 2016, Volume: 19 Issue: 2, 76 - 84, 01.08.2016

Abstract











Giriş:
Transkateter aort valv implantasyonu (TAVİ) yöntemi
cerrahi kapak replasmanı açısından yüksek riskli veya opere edilemeyen ileri
aort darlığı hastalarında daha güvenilir bir yöntemdir. Biz bu çalışmada
transfemoral (TF)-TAVİ sonrası farklı femoral giriş metodlarının, vasküler
komplikasyonlar ve kontrast bağımlı nefropati (KBN) gelişimi üzerine olan
etkilerini araştırmayı amaçladık.



Hastalar
ve Yöntem:
Haziran 2013-Nisan 2015
tarihleri 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 saat
sonra serum kreatinin değerinde > 0.5 mg/dL artış veya başlangıca göre
%25’ten daha fazla yükselme olarak tanımlandı. Hastalar vasküler giriş
yöntemlerine göre cerrahi cut-down (SCD) ve vasküler kapama cihazı (VCD) olarak
iki gruba ayırıldı.



Bulgular:
Kontrast madde (KM) miktarı (p< 0.001) ve KBN
insidansı (p= 0.038) VCD grubunda fazlaydı. Bazal glomerüler filtrasyon oranı
(GFO), bazal kreatinin, Mehran skoru ve KM’nin, KBN gelişiminin belirleyicileri
oldukları saptandı. ROC analizleri sonucunda; KBN gelişimini belirleyici KM
değerinin 178.5 mL ve GFO’nun 48.9 mL/dakika/1.73 m2 olduğu
belirlendi.



Sonuç:
Çeşitli nedenlerle kullanılacak KM miktarı
artabilecek, GFO 48.9’un altında olan TAVİ hastalarında femoral arteriyel
prosedürler için VCD yerine SCD yöntemi tercih edilebilir.



References

  • 1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet 2006;368:1005-11.
  • 2. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Spontaneous course of aortic valve disease. Eur Heart J 1987;8:471-83.
  • 3. Bach DS, Cimino N, Deeb GM. Unoperated patients with severe aortic stenosis. J Am Coll Cardiol 2007;50:2018-9.
  • 4. Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P, et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J 2005;26:2714-20.
  • 5. Bouma BJ, van Den Brink RB, van Der Meulen JH, Verheul HA, Cheriex EC, Hamer HP, et al. To operate or not on elderly patients with aortic stenosis: the decision and its consequences. Heart 1999;82:143-8.
  • 6. Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, et al. Two-year out comes after transcatheter or surgical aortic-valve replacement. New Engl J Med 2012;366:1686-95.
  • 7. Figulla L, Neumann A, Figulla HR, Kahlert P, Erbel R, Neumann T. Transcatheter aortic valve implantation: evidence on safety and efficacy compared with medical therapy. A systematic review of current literature. Clin Res Cardiol 2011;100:265-76.
  • 8. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. PARTNER Trial Investigator. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010;363:1597-607.
  • 9. Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al; CoreValve US Clinical Investigators. Transcatheter aorticvalve replacement with a self-expanding prosthesis. N Engl J Med 2014;370:1790-8.
  • 10. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002;105:2259-64.
  • 11. Aregger F, Wenaweser P, Hellige GJ, Kadner A, Carrel T, Windecker S, et al. Risk of acute kidney injury in patients with severe aortic valve stenosis undergoing transcatheter valve replacement. Nephrol Dial Transplant 2009;24:2175-9.
  • 12. Nuis RJ, Van Mieghem NM, Tzikas A, Piazza N, Otten AM, Cheng J, et al. Frequency, determinants and prognostic effects of acute kidney injury and red blood cell transfusion in patients undergoing transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2011;77:881-9.
  • 13. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930-6.
  • 14. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 2006;100:11-1.
  • 15. Dangas G, Iakovou I, Nikolsky E, Aymong ED, Mintz GS, Kipshidze NN, et al. Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. Am J Cardiol 2005;95:13-9.
  • 16. Yamamoto M, Hayashida K, Mouillet G, Chevalier B, Meguro K, Watanabe Y, et al. Renal function-based contrast dosing predicts acute kidney injury following transcatheter aortic valve implantation. J Am Coll Cardiol Cardiovasc Interv 2013;6:479-86.
  • 17. Gul I, Zungur M, Tastan A, Okur FF, Damar E, Uyar S, et al. The Importance of Contrast Volume/Glomerular Filtration Rate Ratio in Contrast- Induced Nephropathy Patients after Transcatheter Aortic Valve Implantation. Cardiorenal Med 2015;5:31-9.
  • 18. Hayashida K, Lefevre T, Chevalier B, Hovasse T, Romano M, Garot P, et al. Transfemoral aortic valve implantation: new criteria to predict vascular complications. J Am Coll Cardiol Intv 2011;4:851-8.
  • 19. Eisenack M, Umscheid T, Tessarek J, Torsello GF, Torsello GB. Percutaneous endovascular aortic aneurysm repair: a prospective evaluation of safety, efficiency, and risk factors. J Endovasc Ther 2009;16:708-13.
  • 20. Watelet J, Gallot JC, Thomas P, Douvrin F, Plissonnier D. Percutaneous repair of aortic aneurysms: a prospective study of suturemediated closure devices. Eur J Vasc Endovasc Surg 2006;32:261-5.
  • 21. Kahlert P, Al-Rashid F, Weber M, Wendt D, Heine T, Kottenberg E, et al. Vascular access site complications after percutaneous transfemoral aortic valve implantation. Herz 2009;34:398-408.
  • 22. Van Mieghem NM, Nuis RJ, Piazza N, Apostolos T, Ligthart J, Schultz C, et al. Vascular complications with transcatheter aortic valve implantation using the 18 Fr Medtronic CoreValve System: the Rotterdam experience. EuroIntervention 2010;5:673-9.
  • 23. Généreux P, Webb JG, Svensson LG, Kodali SK, Satler LF, Fearon WF, et al; PARTNER Trial Investigators. Vascular complications after transcatheter aortic valve replacement: insights from the PARTNER (Placement of AoRTic TraNscathetER Valve) trial. J Am Coll Cardiol 2012;60:1043-52.
  • 24. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, et al. ESC Committee for Practice Guidelines (CPG); Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS): Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012;42:1-44.
  • 25. Leon MB, Piazza N, Nikolsky E, Blackstone EH, Cutlip DE, Kappetein AP, et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium. Eur Heart J 2011;32:205-17.
  • 26. Chertow GM, Levy EM, Hammermeister KE, Grover F, Daley J. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med 1998;104:343-8.
  • 27. Karkouti K, Wijeysundera DN, Yau TM, Callum JL, Cheng DC, Crowther M, et al. Acute kidney injury after cardiac surgery: focus on modifiable risk factors. Circulation 2009;119:495-502.
  • 28. Lok CE, Austin PC, Wang H, Tu JV. Impact of renal insufficiency on short- and long-term outcomes after cardiac surgery. Am Heart J 2004;148:430-8.
  • 29. Bagur R, Webb JG, Nietlispach F, Dumont E, De Larochellière R, Doyle D, et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J 2010;31:865-74.
  • 30. Lange R, Bleiziffer S, Piazza N, Mazzitelli D, Hutter A, Tassani-Prell P, et al. Incidence and treatment of procedural cardiovascular complications associated with trans-arterial and trans-apical interventional aortic valve implantation in 412 consecutive patients. Eur J Cardiothorac Surg 2011;40:1105-13.
  • 31. Hayashida K, Lefèvre T, Chevalier B, Hovasse T, Romano M, Garot P, et al. True percutaneous approach for transfemoral aortic valve implantation using the Prostar XL device: impact of learning curve on vascular complications. J Am Coll Cardiol Cardiovasc Interv 2012;5:207-14.
  • 32. Bernardi FL, Gomes WF, de Brito FS Jr, Mangione JA, Sarmento-Leite R, Siqueira D, et al. Surgical cutdown versus percutaneous access in transfemoral transcatheter aortic valve implantation: Insights from the Brazilian TAVI registry. Catheter Cardiovasc Interv 2015;86:501-5.

Importance of Femoral Access Method in Predicting the Development of Contrast Induced Nephropathy after Transfemoral Transcatheter Aortic Valve Implantation

Year 2016, Volume: 19 Issue: 2, 76 - 84, 01.08.2016

Abstract











Introduction:
Transcatheter aortic valve implantation (TAVI) is
more reliable than surgical valve replacement for high-risk or inoperable
aortic stenosis patients. In this study, we aimed to investigate the effects of
different femoral access methods on the development of vascular complications
and contrast-induced nephropathy (CIN) after transfemoral (TF)-TAVI.



Patients
and Methods:
In total, 110 patients (aged 78.9 ± 12.2
years; 55 females) who underwent aortic valve replacement by TF-TAVI between
June 2013 and April 2015 were included in the study. CIN was defined as an
absolute increase in serum creatinine level of > 0.5 mg/dL or a relative
increase of > 25% within 48-72 h after TF-TAVI. The patients were classified
into 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) and
the incidence of CIN (p= 0.038) were higher in the VCD group. Baseline
glomerular filtration rate (GFR), baseline creatinine, Mehran score and CM were
determined as the predictive factors of CIN development. Receiver operating
characteristic analysis revealed that CM, which may predict the development of
CIN, was determined as 178.5 mL, and GFR, which may predict the development of
CIN, was determined as 48.9 mL/dk/1.73 m2.



Conclusion:
It may be preferred to perform the femoral arterial
procedure 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.



References

  • 1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet 2006;368:1005-11.
  • 2. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Spontaneous course of aortic valve disease. Eur Heart J 1987;8:471-83.
  • 3. Bach DS, Cimino N, Deeb GM. Unoperated patients with severe aortic stenosis. J Am Coll Cardiol 2007;50:2018-9.
  • 4. Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P, et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J 2005;26:2714-20.
  • 5. Bouma BJ, van Den Brink RB, van Der Meulen JH, Verheul HA, Cheriex EC, Hamer HP, et al. To operate or not on elderly patients with aortic stenosis: the decision and its consequences. Heart 1999;82:143-8.
  • 6. Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, et al. Two-year out comes after transcatheter or surgical aortic-valve replacement. New Engl J Med 2012;366:1686-95.
  • 7. Figulla L, Neumann A, Figulla HR, Kahlert P, Erbel R, Neumann T. Transcatheter aortic valve implantation: evidence on safety and efficacy compared with medical therapy. A systematic review of current literature. Clin Res Cardiol 2011;100:265-76.
  • 8. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. PARTNER Trial Investigator. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010;363:1597-607.
  • 9. Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al; CoreValve US Clinical Investigators. Transcatheter aorticvalve replacement with a self-expanding prosthesis. N Engl J Med 2014;370:1790-8.
  • 10. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002;105:2259-64.
  • 11. Aregger F, Wenaweser P, Hellige GJ, Kadner A, Carrel T, Windecker S, et al. Risk of acute kidney injury in patients with severe aortic valve stenosis undergoing transcatheter valve replacement. Nephrol Dial Transplant 2009;24:2175-9.
  • 12. Nuis RJ, Van Mieghem NM, Tzikas A, Piazza N, Otten AM, Cheng J, et al. Frequency, determinants and prognostic effects of acute kidney injury and red blood cell transfusion in patients undergoing transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2011;77:881-9.
  • 13. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930-6.
  • 14. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 2006;100:11-1.
  • 15. Dangas G, Iakovou I, Nikolsky E, Aymong ED, Mintz GS, Kipshidze NN, et al. Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. Am J Cardiol 2005;95:13-9.
  • 16. Yamamoto M, Hayashida K, Mouillet G, Chevalier B, Meguro K, Watanabe Y, et al. Renal function-based contrast dosing predicts acute kidney injury following transcatheter aortic valve implantation. J Am Coll Cardiol Cardiovasc Interv 2013;6:479-86.
  • 17. Gul I, Zungur M, Tastan A, Okur FF, Damar E, Uyar S, et al. The Importance of Contrast Volume/Glomerular Filtration Rate Ratio in Contrast- Induced Nephropathy Patients after Transcatheter Aortic Valve Implantation. Cardiorenal Med 2015;5:31-9.
  • 18. Hayashida K, Lefevre T, Chevalier B, Hovasse T, Romano M, Garot P, et al. Transfemoral aortic valve implantation: new criteria to predict vascular complications. J Am Coll Cardiol Intv 2011;4:851-8.
  • 19. Eisenack M, Umscheid T, Tessarek J, Torsello GF, Torsello GB. Percutaneous endovascular aortic aneurysm repair: a prospective evaluation of safety, efficiency, and risk factors. J Endovasc Ther 2009;16:708-13.
  • 20. Watelet J, Gallot JC, Thomas P, Douvrin F, Plissonnier D. Percutaneous repair of aortic aneurysms: a prospective study of suturemediated closure devices. Eur J Vasc Endovasc Surg 2006;32:261-5.
  • 21. Kahlert P, Al-Rashid F, Weber M, Wendt D, Heine T, Kottenberg E, et al. Vascular access site complications after percutaneous transfemoral aortic valve implantation. Herz 2009;34:398-408.
  • 22. Van Mieghem NM, Nuis RJ, Piazza N, Apostolos T, Ligthart J, Schultz C, et al. Vascular complications with transcatheter aortic valve implantation using the 18 Fr Medtronic CoreValve System: the Rotterdam experience. EuroIntervention 2010;5:673-9.
  • 23. Généreux P, Webb JG, Svensson LG, Kodali SK, Satler LF, Fearon WF, et al; PARTNER Trial Investigators. Vascular complications after transcatheter aortic valve replacement: insights from the PARTNER (Placement of AoRTic TraNscathetER Valve) trial. J Am Coll Cardiol 2012;60:1043-52.
  • 24. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, et al. ESC Committee for Practice Guidelines (CPG); Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS): Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012;42:1-44.
  • 25. Leon MB, Piazza N, Nikolsky E, Blackstone EH, Cutlip DE, Kappetein AP, et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium. Eur Heart J 2011;32:205-17.
  • 26. Chertow GM, Levy EM, Hammermeister KE, Grover F, Daley J. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med 1998;104:343-8.
  • 27. Karkouti K, Wijeysundera DN, Yau TM, Callum JL, Cheng DC, Crowther M, et al. Acute kidney injury after cardiac surgery: focus on modifiable risk factors. Circulation 2009;119:495-502.
  • 28. Lok CE, Austin PC, Wang H, Tu JV. Impact of renal insufficiency on short- and long-term outcomes after cardiac surgery. Am Heart J 2004;148:430-8.
  • 29. Bagur R, Webb JG, Nietlispach F, Dumont E, De Larochellière R, Doyle D, et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J 2010;31:865-74.
  • 30. Lange R, Bleiziffer S, Piazza N, Mazzitelli D, Hutter A, Tassani-Prell P, et al. Incidence and treatment of procedural cardiovascular complications associated with trans-arterial and trans-apical interventional aortic valve implantation in 412 consecutive patients. Eur J Cardiothorac Surg 2011;40:1105-13.
  • 31. Hayashida K, Lefèvre T, Chevalier B, Hovasse T, Romano M, Garot P, et al. True percutaneous approach for transfemoral aortic valve implantation using the Prostar XL device: impact of learning curve on vascular complications. J Am Coll Cardiol Cardiovasc Interv 2012;5:207-14.
  • 32. Bernardi FL, Gomes WF, de Brito FS Jr, Mangione JA, Sarmento-Leite R, Siqueira D, et al. Surgical cutdown versus percutaneous access in transfemoral transcatheter aortic valve implantation: Insights from the Brazilian TAVI registry. Catheter Cardiovasc Interv 2015;86:501-5.
There are 32 citations in total.

Details

Primary Language English
Journal Section Original Investigations
Authors

İlker Gül This is me

Mustafa Zungur This is me

Ahmet Taştan This is me

Muhammed Esad Çekin This is me

Ahmet Çağrı Aykan This is me

Aysel İslamlı This is me

Talat Tavlı This is me

Publication Date August 1, 2016
Published in Issue Year 2016 Volume: 19 Issue: 2

Cite

Vancouver Gül İ, Zungur M, Taştan A, Çekin ME, Aykan AÇ, İslamlı A, Tavlı T. Importance of Femoral Access Method in Predicting the Development of Contrast Induced Nephropathy after Transfemoral Transcatheter Aortic Valve Implantation. Koşuyolu Heart Journal. 2016;19(2):76-84.