Journal of Chest Surgery

  • 제55권6호
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  • Pages.435-441
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  • 2022
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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The Impact of Surgical versus Transcatheter Aortic Valve Replacement on Postprocedural Acute Kidney Injury in Patients with Chronic Kidney Disease

  • Eun Chae, Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Sue Hyun, Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Yeiwon, Lee (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Suk Ho, Sohn (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jae Woong, Choi (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jeehoon, Kang (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jung Kyu, Han (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kyung Hwan, Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hyo-Soo, Kim (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Ho Young, Hwang (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • 투고 : 2022.04.19
  • 심사 : 2022.08.13
  • 발행 : 2022.12.05
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초록

Background: This study aimed to evaluate the impact of the treatment modality on post-procedural acute kidney injury (AKI) and other clinical outcomes in patients with advanced chronic kidney disease who underwent surgical or transcatheter aortic valve replacement (AVR). Methods: A total of 147 patients with advanced chronic kidney disease (stage 3 to 5) who underwent isolated surgical AVR (SAVR group; n=70) or transcatheter AVR (TAVR group; n=77) were retrospectively studied. Postprocedural AKI was defined according to the RIFLE definition (an acronym corresponding to the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease). Factors associated with postoperative complications and mortality were analyzed using multivariable logistic regression models and Cox proportional hazard models. Results: Postprocedural AKI occurred in 17 (24.3%) and 6 (7.8%) patients in the SAVR and TAVR groups, respectively (p=0.006). Multivariable analyses demonstrated that the SAVR group had higher risks of AKI (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.85-17.73; p=0.002) and atrial fibrillation (OR, 16.65; 95% CI, 4.44-62.50; p<0.001), whereas the TAVR group had a higher risk of permanent pacemaker insertion (OR, 5.67; 95% CI, 1.21-26.55; p=0.028). The Cox proportional hazard models showed that the occurrence of AKI, contrary to the treatment modality, was associated with overall survival. Conclusion: In patients with chronic kidney disease, the risk of postprocedural AKI might be higher after SAVR than after TAVR.

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참고문헌

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