A Novel Technique for Performing Transfemoral Transcatheter Self-Expanding Aortic Valve Replacement With No Contrast Which Minimizes Acute Kidney Injury.

Autor: Gupta A; Louisiana Children's Medical Center Health System, New Orleans, LA., Prince M; Hospital Corporation of America, Kingwood, Houston, TX., Tafur-Soto J; Gayle and Tom Benson Heart Valve Center, Ochsner Medical Center, New Orleans, LA., Spindel SM; Division of Cardiothoracic Surgery, Ochsner Medical Center, New Orleans, LA. Electronic address: stephenspindel123@gmail.com., Su J; University of Massachusetts, Amherst, MA., Ramee S; Gayle and Tom Benson Heart Valve Center, Ochsner Medical Center, New Orleans, LA.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2024 Jan; Vol. 49 (1 Pt B), pp. 102046. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1016/j.cpcardiol.2023.102046
Abstrakt: Transcatheter aortic valve replacement (TAVR) treats severe aortic stenosis. However, patients with limited renal function may be ineligible for contrast use during valve deployment. We evaluate TAVR via transfemoral approach using 2-wire technique and no contrast injection. Primary endpoints are acute kidney injury and procedural success. Safety analysis includes mortality, stroke, myocardial infarction, coronary obstruction, and more. Forty-six patients were included; most with preserved ejection fraction. Baseline creatinine was 1.63 ± 0.68 and post-TAVR was significantly better (1.47 ± 0.64, P < 0.01). No statistical difference existed between creatinine at baseline and 30 days. After TAVR, 91% had no paravalvular leak (PVL). Peak-velocity post-TAVR was 1.32 ± 0.33 and mean-gradient was 7 ± 4. No valve repositioning during deployment was required. No mortality at 30 days without incidence of stroke, myocardial infarction or coronary obstruction. One patient had retroperitoneal bleeding requiring transfusion. The noncontrast technique for self-expanding valve deployment is feasible and safe in patients who cannot tolerate contrast.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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