Renal Function After Combined Treatment for Coronary Disease and Aortic Valve Replacement.

Autor:	Taghiyev ZT; Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany., Jaeger KE; Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany., Fuchs MV; Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany., Roth P; Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany., Doerr O; Department of Cardiology, University Hospital Giessen, Giessen, Germany., Böning A; Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany.
Jazyk:	angličtina
Zdroj:	The Thoracic and cardiovascular surgeon [Thorac Cardiovasc Surg] 2024 Nov 29. Date of Electronic Publication: 2024 Nov 29.
DOI:	10.1055/a-2493-1495
Abstrakt:	Objectives: A single-center retrospective study was initialized to investigate the occurrence of acute kidney injury (AKI) and its impact on short- and long-term outcomes after aortic valve replacement in patients with aortic stenosis (AS) and complex coronary artery disease (CAD). Methods: Between January 2010 and December 2020, 1,232 patients with severe aortic stenosis (AS) and coronary artery disease (CAD) were treated. Propensity score matching generated 40 patient pairs with intermediate STS risk scores (3.2±0.3) and EUROScore II (4.1±0.3), undergoing percutaneous (TAVR+PCI) or surgical (SAVR+CABG) combined procedures. The renal function-corrected ratio of contrast medium to body weight was calculated to determine the risk of postprocedural contrast medium-associated AKI. Renal retention values were recorded daily until the seventh day after the procedure. Results: The overall incidence of postprocedural AKI was similar between groups. There was no correlation between the contrast medium volume to serum creatinine to body weight ratio and AKI occurrence. During the first seven postprocedural days, creatinine clearance values were comparable: 68.97 ± 4.92 ml/min (SAVR+CABG) vs. 64.95 ± 9.78 ml/min (TAVR+PCI), mean difference 4.02, 95% CI [-24.5 to 16.4], p=0.691. 35% (8/23) of patients with renal impairment had improved renal function on the seventh day after the procedure. No correlation between impaired renal function and short- or long-term mortality was found in multivariable models. Conclusion: Contrast agents may temporarily impair renal function during a minimally invasive percutaneous approach; however, occurrence of AKI was not related to the amount of contrast medium, and AKI was not associated with short- and long-term mortality. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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