Transcatheter aortic valve implantation in dialysis patients

Simon Rau, Matthias Wessely, Philipp Lange, Christian Kupatt, Gerhard Steinbeck, Michael Fischereder, Ulf Schnermarck

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background/Aims: Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option for high-risk patients. However, dialysis patients were excluded from all previous studies. The aim of this study is to compare the outcomes of TAVI for dialysis patients with those for patients with chronic kidney disease (CKD) stages 3 and 4 and to compare TAVI with open surgery in dialysis patients. Methods: Part I: comparison of 10 patients on chronic hemodialysis with 116 patients with non-dialysis-dependent CKD undergoing TAVI. Part II: comparison of transcatheter (n = 15) with open surgical (n = 24) aortic valve replacement in dialysis patients. Results: Part I: dialysis patients were significantly younger (72.3 vs. 82.0 years; p < 0.01). Hospital stay was significantly longer in dialysis patients (21.8 vs. 12.1 days; p = 0.01). Overall 30-day mortality was 3.17%, with no deaths among dialysis patients. Six-month survival rates were similar (log-rank p = 0.935). Part II: patient age was comparable (66.5 vs. 69.5 years; p = 0.42). Patients in the surgical group tended to stay longer in hospital than TAVI patients (29.5 vs. 22.5 days; p = 0.35). Conclusion: TAVI is a safe procedure in patients on chronic hemodialysis. Until new data become available, we find no compelling reason to refuse these patients TAVI.

Original languageEnglish
Pages (from-to)c86-c90
JournalNephron - Clinical Practice
Volume120
Issue number2
DOIs
StatePublished - May 2012
Externally publishedYes

Keywords

  • Aortic stenosis
  • Dialysis
  • Surgical aortic valve replacement
  • Transcatheter aortic valve implantation

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