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23.09.2020 | Original Paper

Transcatheter or surgical aortic valve implantation in chronic dialysis patients: a German Aortic Valve Registry analysis

verfasst von: Gloria Färber, Sabine Bleiziffer, Torsten Doenst, Dimitra Bon, Andreas Böning, Helge Weiler, Eva Herrmann, Christian Frerker, Andreas Beckmann, Helge Möllmann, Stephan Ensminger, Raffi Bekeredjian, Thomas Walther, Wolfgang Harringer, Hugo A. Katus, Christian W. Hamm, Friedhelm Beyersdorf, Timm Bauer, Stephan Fichtlscherer, For the GARY Executive Board

Erschienen in: Clinical Research in Cardiology | Ausgabe 3/2021

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Abstract

Objectives

The aim of this study was to compare outcomes of transcatheter and surgical aortic valve implantation in chronic dialysis patients with aortic valve stenosis (AS).

Background

Chronic dialysis patients undergoing heart valve surgery are at higher risk for morbidity and mortality. Whether interventional techniques can reduce this risk is unclear because dialysis patients have thus far been excluded from randomized trials.

Methods

Chronic dialysis patients with AS enrolled in the German Aortic Valve Registry (GARY) between 2012 and 2015 were analyzed to compare transcatheter aortic valve implantation (TAVI n = 661) with surgical aortic valve replacement (SAVR n = 457). Propensity scores for inverse probability of treatment weighting (IPTW) were used to adjust the comparison of the two treatment groups for potential confounders.

Results

TAVI patients were older (78 ± 7.3 vs. 69 ± 10.2 years, p < 0.01, unadjusted) and had more comorbidities. Mortality at 1 year was the same (TAVI: 33.4% vs. SAVR 35.0%, p = 0.72, IPTW-adjusted) while it was lower with TAVI at 30 days (8.6% vs. 15.0%, p = 0.02, IPTW-adjusted). TAVI patients required more pacemaker implantation and showed more aortic regurgitation. SAVR patients required more blood transfusions and had longer hospital stay. Diabetes mellitus, atrial fibrillation, previous PCI, urgent procedure and EuroSCORE were associated with elevated 30-day mortality. Atrial fibrillation and older age were independent risk factor of 1-year mortality in both groups.

Conclusions

Chronic dialysis patients with AS undergoing TAVI or SAVR had the same 1-year mortality, although survival at 30 days was better with TAVI. These results suggest that TAVI may improve peri-procedural outcomes.

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Saran R, Robinson B, Abbott KC, Agodoa LYC, Bhave N, Bragg-Gresham J, Balkrishnan R, Dietrich X, Eckard A, Eggers PW, Gaipov A, Gillen D, Gipson D, Hailpern SM, Hall YN, Han Y, He K, Herman W, Heung M, Hirth RA, Hutton D, Jacobsen SJ, Jin Y, Kalantar-Zadeh K, Kapke A, Kovesdy CP, Lavallee D, Leslie J, McCullough K, Modi Z, Molnar MZ, Montez-Rath M, Moradi H, Morgenstern H, Mukhopadhyay P, Nallamothu B, Nguyen DV, Norris KC, O’Hare AM, Obi Y, Park C, Pearson J, Pisoni R, Potukuchi PK, Rao P, Repeck K, Rhee CM, Schrager J, Schaubel DE, Selewski DT, Shaw SF, Shi JM, Shieu M, Sim JJ, Soohoo M, Steffick D, Streja E, Sumida K, Tamura MK, Tilea A, Tong L, Wang D, Wang M, Woodside KJ, Xin X, Yin M, You AS, Zhou H, Shahinian V (2018) US renal data system 2017 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 71(3s1):A7. https://doi.org/10.1053/j.ajkd.2018.01.002CrossRefPubMedPubMedCentral

Maher ER, Pazianas M, Curtis JR (1987) Calcific aortic stenosis: a complication of chronic uraemia. Nephron 47(2):119–122. https://doi.org/10.1159/000184472CrossRefPubMed

Braun J, Oldendorf M, Moshage W, Heidler R, Zeitler E, Luft FC (1996) Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients. Am J Kidney Dis 27(3):394–401CrossRefPubMed

Baglin A, Hanslik T, Vaillant JN, Boulard JC, Moulonguet-Doleris L, Prinseau J (1997) Severe valvular heart disease in patients on chronic dialysis. A five-year multicenter French survey. Ann Med Intern (Paris) 148(8):521–526

Urena P, Malergue MC, Goldfarb B, Prieur P, Guedon-Rapoud C, Petrover M (1999) Evolutive aortic stenosis in hemodialysis patients: analysis of risk factors. Nephrologie 20(4):217–225PubMed

Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A (2017) 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation 135(25):e1159–e1195. https://doi.org/10.1161/CIR.0000000000000503CrossRefPubMed

Falk V, Baumgartner H, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Munoz DR, Rosenhek R, Sjogren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL, Group ESCSD (2017) 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg 52(4):616–664. https://doi.org/10.1093/ejcts/ezx324CrossRefPubMed

Aljohani S, Alqahtani F, Almustafa A, Boobes K, Modi S, Alkhouli M (2017) Trends and Outcomes of Aortic Valve Replacement in Patients With End-Stage Renal Disease on Hemodialysis. Am J Cardiol 120(9):1626–1632. https://doi.org/10.1016/j.amjcard.2017.07.063CrossRefPubMed

Alqahtani F, Aljohani S, Boobes K, Maor E, Sherieh A, Rihal CS, Holmes DR, Alkhouli M (2017) Outcomes of transcatheter and surgical aortic valve replacement in patients. Am J Med 130(12):1464. https://doi.org/10.1016/j.amjmed.2017.05.031(e1461–1464 e1411)CrossRefPubMedPubMedCentral

10.

Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, Derumeaux G, Anselme F, Laborde F, Leon MB (2002) Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation 106(24):3006–3008CrossRefPubMed

11.

Thyregod HG, Steinbruchel DA, Ihlemann N, Nissen H, Kjeldsen BJ, Petursson P, Chang Y, Franzen OW, Engstrom T, Clemmensen P, Hansen PB, Andersen LW, Olsen PS, Sondergaard L (2015) Transcatheter versus surgical aortic valve replacement in patients with severe aortic valve stenosis: 1-year results from the all-comers NOTION randomized clinical trial. J Am Coll Cardiol 65(20):2184–2194. https://doi.org/10.1016/j.jacc.2015.03.014CrossRefPubMed

12.

Thourani VH, Kodali S, Makkar RR, Herrmann HC, Williams M, Babaliaros V, Smalling R, Lim S, Malaisrie SC, Kapadia S, Szeto WY, Greason KL, Kereiakes D, Ailawadi G, Whisenant BK, Devireddy C, Leipsic J, Hahn RT, Pibarot P, Weissman NJ, Jaber WA, Cohen DJ, Suri R, Tuzcu EM, Svensson LG, Webb JG, Moses JW, Mack MJ, Miller DC, Smith CR, Alu MC, Parvataneni R, D'Agostino RB Jr, Leon MB (2016) Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet 387(10034):2218–2225. https://doi.org/10.1016/S0140-6736(16)30073-3CrossRefPubMed

13.

Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Sondergaard L, Mumtaz M, Adams DH, Deeb GM, Maini B, Gada H, Chetcuti S, Gleason T, Heiser J, Lange R, Merhi W, Oh JK, Olsen PS, Piazza N, Williams M, Windecker S, Yakubov SJ, Grube E, Makkar R, Lee JS, Conte J, Vang E, Nguyen H, Chang Y, Mugglin AS, Serruys PW, Kappetein AP, Investigators S (2017) Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med 376(14):1321–1331. https://doi.org/10.1056/NEJMoa1700456CrossRefPubMed

14.

Reardon MJ, Kleiman NS, Adams DH, Yakubov SJ, Coselli JS, Deeb GM, O'Hair D, Gleason TG, Lee JS, Hermiller JB Jr, Chetcuti S, Heiser J, Merhi W, Zorn GL 3rd, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Maini B, Mumtaz M, Conte JV, Resar JR, Aharonian V, Pfeffer T, Oh JK, Huang J, Popma JJ (2016) Outcomes in the randomized CoreValve US pivotal high risk trial in patients with a society of thoracic surgeons risk score of 7% or less. JAMA Cardiol 1(8):945–949. https://doi.org/10.1001/jamacardio.2016.2257CrossRefPubMed

15.

Hamm CW, Arsalan M, Mack MJ (2016) The future of transcatheter aortic valve implantation. Eur Heart J 37(10):803–810. https://doi.org/10.1093/eurheartj/ehv574CrossRefPubMed

16.

Mollmann H, Husser O, Blumenstein J, Liebetrau C, Dorr O, Kim WK, Nef H, Tesche C, Hamm CW, Elsasser A, Achenbach S, Gaede L (2020) Lower mortality in an all-comers aortic stenosis population treated with TAVI in comparison to SAVR. Clin Res Cardiol 109(5):611–615. https://doi.org/10.1007/s00392-019-01548-1CrossRefPubMed

17.

Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Brown DL, Block PC, Guyton RA, Pichard AD, Bavaria JE, Herrmann HC, Douglas PS, Petersen JL, Akin JJ, Anderson WN, Wang DL, Pocock S, Investigators PT (2010) Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. New Engl J Med 363(17):1597–1607. https://doi.org/10.1056/NEJMoa1008232CrossRefPubMed

18.

Smith CR, Leon MB, Mack MJ, Miller C, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Williams M, Dewey T, Kapadia S, Babaliaros V, Thourani VH, Corso P, Pichard AD, Bavaria JE, Herrmann HC, Akin JJ, Anderson WN, Wang DL, Pocock SJ, Investigators PT (2011) Transcatheter versus surgical aortic-valve replacement in high-risk patients. New Engl J Med 364(23):2187–2198. https://doi.org/10.1056/NEJMoa1103510CrossRefPubMed

19.

Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, Gleason TG, Buchbinder M, Hermiller J, Kleiman NS, Chetcuti S, Heiser J, Merhi W, Zorn G, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Conte J, Maini B, Mumtaz M, Chenoweth S, Oh JK, Investigator UCC (2014) Transcatheter aortic-valve replacement with a self-expanding prosthesis. New Engl J Med 370(19):1790–1798. https://doi.org/10.1056/NEJMoa1400590CrossRefPubMed

20.

von Scheidt W, Welz A, Pauschinger M, Fischlein T, Schachinger V, Treede H, Zahn R, Hennersdorf M, Albes JM, Bekeredjian R, Beyer M, Brachmann J, Butter C, Bruch L, Dorge H, Eichinger W, Franke UFW, Friedel N, Giesler T, Gradaus R, Hambrecht R, Haude M, Hausmann H, Heintzen MP, Jung W, Kerber S, Mudra H, Nordt T, Pizzulli L, Sack FU, Sack S, Schumacher B, Schymik G, Sechtem U, Stellbrink C, Stumpf C, Hoffmeister HM (2020) Interdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI): Joint Consensus Document of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausarzte e.V. (ALKK) and cooperating Cardiac Surgery Departments. Clin Res Cardiol 109(1):1–12. https://doi.org/10.1007/s00392-019-01528-5CrossRef

21.

Beckmann A, Hamm C, Figulla HR, Cremer J, Kuck KH, Lange R, Zahn R, Sack S, Schuler GC, Walther T, Beyersdorf F, Bohm M, Heusch G, Funkat AK, Meinertz T, Neumann T, Papoutsis K, Schneider S, Welz A, Mohr FW, Board GE (2012) The German Aortic Valve Registry (GARY): a nationwide registry for patients undergoing invasive therapy for severe aortic valve stenosis. Thorac Cardiovasc Surg 60(5):319–325. https://doi.org/10.1055/s-0032-1323155CrossRefPubMed

22.

Austin PC, Stuart EA (2015) Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Stat Med 34(28):3661–3679. https://doi.org/10.1002/sim.6607CrossRefPubMedPubMedCentral

23.

Jochheim D, Barbanti M, Capretti G, Stefanini GG, Hapfelmeier A, Zadrozny M, Baquet M, Fischer J, Theiss H, Todaro D, Chieffo A, Presbitero P, Colombo A, Massberg S, Tamburino C, Mehilli J (2019) Oral anticoagulant type and outcomes after transcatheter aortic valve replacement. JACC Cardiovasc Interv 12(16):1566–1576. https://doi.org/10.1016/j.jcin.2019.03.003CrossRefPubMed

24.

Ridgeway G, Dan McCaffrey D, Morral A, Griffin BA, Burgette L (2016) Twang. Toolkit for weighting and analysis of nonequivalent groups. https://CRAN.R-projectorg/package=twang. Accessed 27 July 2020

25.

Lumley T (2004) Analysis of complex survey samples. J Stat Softw 9(1):1–19

26.

Condado JF, Maini A, Leshnower B, Thourani V, Forcillo J, Devireddy C, Mavromatis K, Sarin EL, Stewart J, Guyton R, Simone A, Keegan P, Lerakis S, Block PC, Babaliaros V (2017) End-stage renal disease and severe aortic stenosis: does valve replacement improve one-year outcomes? Catheter Cardiovasc Interv 89(6):1109–1115. https://doi.org/10.1002/ccd.26875CrossRefPubMed

27.

Szerlip M, Zajarias A, Vemalapalli S, Brennan M, Dai D, Maniar H, Lindman BR, Brindis R, Carroll JD, Hamandi M, Edwards FH, Grover F, O'Brien S, Peterson E, Rumsfeld JS, Shahian D, Tuzcu EM, Holmes D, Thourani VH, Mack M (2019) Transcatheter aortic valve replacement in patients with end-stage renal disease. J Am Coll Cardiol 73(22):2806–2815. https://doi.org/10.1016/j.jacc.2019.03.496CrossRefPubMed

28.

Mohr FW, Holzhey D, Mollmann H, Beckmann A, Veit C, Figulla HR, Cremer J, Kuck KH, Lange R, Zahn R, Sack S, Schuler G, Walther T, Beyersdorf F, Bohm M, Heusch G, Funkat AK, Meinertz T, Neumann T, Papoutsis K, Schneider S, Welz A, Hamm CW (2014) The German Aortic Valve Registry: 1-year results from 13,680 patients with aortic valve disease. Eur J Cardiothorac Surg 46(5):808–816. https://doi.org/10.1093/ejcts/ezu290CrossRefPubMed

29.

Blumenstein J, Mollmann H, Bleiziffer S, Bauer T, Ensminger S, Bekeredjian R, Walther T, Frerker C, Beyersdorf F, Hamm C, Beckmann A (2020) Transcatheter aortic valve implantation in nonagenarians: insights from the German Aortic Valve Registry (GARY). Clin Res Cardiol. https://doi.org/10.1007/s00392-020-01601-4CrossRefPubMed

30.

Dumonteil N, van der Boon RM, Tchetche D, Chieffo A, Van Mieghem NM, Marcheix B, Buchanan GL, Vahdat O, Serruys PW, Fajadet J, Colombo A, de Jaegere PP, Carrie D (2013) Impact of preoperative chronic kidney disease on short- and long-term outcomes after transcatheter aortic valve implantation: a Pooled-RotterdAm-Milano-Toulouse In Collaboration Plus (PRAGMATIC-Plus) initiative substudy. Am Heart J 165(5):752–760. https://doi.org/10.1016/j.ahj.2012.12.013CrossRefPubMed

31.

Winkelmayer WC, Levin R, Avorn J (2003) Chronic kidney disease as a risk factor for bleeding complications after coronary artery bypass surgery. Am J Kidney Dis 41(1):84–89. https://doi.org/10.1053/ajkd.2003.50026CrossRefPubMed

32.

Capodanno D, Angiolillo DJ (2012) Antithrombotic pharmacotherapy in the elderly: general issues and clinical conundrums. Curr Treat Options Cardiovasc Med 14(1):57–68. https://doi.org/10.1007/s11936-011-0153-6CrossRefPubMed

33.

Palmer SC, Di Micco L, Razavian M, Craig JC, Perkovic V, Pellegrini F, Copetti M, Graziano G, Tognoni G, Jardine M, Webster A, Nicolucci A, Zoungas S, Strippoli GF (2012) Effects of antiplatelet therapy on mortality and cardiovascular and bleeding outcomes in persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med 156(6):445–459. https://doi.org/10.7326/0003-4819-156-6-201203200-00007CrossRefPubMed

34.

Olesen JB, Lip GY, Kamper AL, Hommel K, Kober L, Lane DA, Lindhardsen J, Gislason GH, Torp-Pedersen C (2012) Stroke and bleeding in atrial fibrillation with chronic kidney disease. N Engl J Med 367(7):625–635. https://doi.org/10.1056/NEJMoa1105594CrossRefPubMed

35.

Roldan V, Marin F (2012) Oral anticoagulation in chronic kidney disease: a huge challenge. Thromb Haemost 108(1):3–5. https://doi.org/10.1160/TH12-05-0324CrossRefPubMed

36.

Remuzzi G (1988) Bleeding in renal failure. Lancet 1(8596):1205–1208CrossRefPubMed

37.

Mikhail A, Brown C, Williams JA, Mathrani V, Shrivastava R, Evans J, Isaac H, Bhandari S (2017) Renal association clinical practice guideline on anaemia of chronic kidney disease. BMC Nephrol 18(1):345. https://doi.org/10.1186/s12882-017-0688-1CrossRefPubMedPubMedCentral

38.

Allende R, Webb JG, Munoz-Garcia AJ, de Jaegere P, Tamburino C, Dager AE, Cheema A, Serra V, Amat-Santos I, Velianou JL, Barbanti M, Dvir D, Alonso-Briales JH, Nuis RJ, Faqiri E, Imme S, Benitez LM, Cucalon AM, Al Lawati H, Garcia del Blanco B, Lopez J, Natarajan MK, DeLarochelliere R, Urena M, Ribeiro HB, Dumont E, Nombela-Franco L, Rodes-Cabau J (2014) Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: insights on clinical outcomes and prognostic markers from a large cohort of patients. Eur Heart J 35(38):2685–2696. https://doi.org/10.1093/eurheartj/ehu175CrossRefPubMed

39.

Lange R, Beckmann A, Neumann T, Krane M, Deutsch MA, Landwehr S, Kotting J, Welz A, Zahn R, Cremer J, Figulla HR, Schuler G, Holzhey DM, Funkat AK, Heusch G, Sack S, Pasic M, Meinertz T, Walther T, Kuck KH, Beyersdorf F, Bohm M, Mollmann H, Hamm CW, Mohr FW, Board GE (2016) Quality of life after transcatheter aortic valve replacement: prospective data from GARY (German Aortic Valve Registry). JACC Cardiovasc Interv 9(24):2541–2554. https://doi.org/10.1016/j.jcin.2016.09.050CrossRefPubMed

Titel: Transcatheter or surgical aortic valve implantation in chronic dialysis patients: a German Aortic Valve Registry analysis
verfasst von: Gloria Färber
Sabine Bleiziffer
Torsten Doenst
Dimitra Bon
Andreas Böning
Helge Weiler
Eva Herrmann
Christian Frerker
Andreas Beckmann
Helge Möllmann
Stephan Ensminger
Raffi Bekeredjian
Thomas Walther
Wolfgang Harringer
Hugo A. Katus
Christian W. Hamm
Friedhelm Beyersdorf
Timm Bauer
Stephan Fichtlscherer
For the GARY Executive Board
Publikationsdatum: 23.09.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 3/2021
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-020-01717-7

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Transcatheter or surgical aortic valve implantation in chronic dialysis patients: a German Aortic Valve Registry analysis

Abstract

Objectives

Background

Methods

Results

Conclusions

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Conclusions

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