Abstract: PUB565
Mortality Outcomes of Patients with CKD Underdoing Transcatheter Aortic Valve Replacement at Cooper University Hospital
Session Information
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Chau, Michael, Rowan University Cooper Medical School, Camden, New Jersey, United States
- Hunter, Krystal, Cooper University Health Care, Camden, New Jersey, United States
- McFadden, Christopher B., Rowan University Cooper Medical School, Camden, New Jersey, United States
Background
Chronic kidney disease (CKD) is a major risk factor for valvular heart disease, specifically aortic valve calcification. The prevalence and progression of aortic stenosis is higher and faster in patients with CKD thus many of these patients undergo transcatheter aortic valve replacement (TAVR) in their respective lifetimes. Many studies have reported that in-hospital morbidity and mortality are significantly higher in CKD patients when compared to non-CKD patients. However, there are few studies that further distinguish CKD into its different stages and categorize patients on their risk relative to their CKD category. The purpose of this study is to elucidate the mortality outcomes in patients with different stages of CKD following TAVR surgery.
Methods
An IRB approved retrospective study was conducted on patients who underwent TAVR at Cooper University Hospital between 02/2020 and 12/2022. The primary outcome was the 1-year mortality rate after TAVR surgery. Patients with CKD were stratified by their estimated glomerular filtration rate (eGFR) calculated with the CKD-EPI Creatinine Equation (2021). Statistical analyses were performed on this dataset to compare outcomes at different stages of CKD on patients who underwent TAVR.
Results
When compared to patients with CKD3a, patients with CKD3b or worse have greater odds of mortality at the 1-year and 3-year mark after undergoing TAVR. When compared to patients with CKD3b, patients with CKD4 did not have a significant difference in mortality at the 1-year and 3-year mark but patients with CKD1, 2, and CKD3a had lower odds of mortality.
Conclusion
Despite advances in technology and increased in operative experience, patients with CKD who undergo TAVR experience a higher risk of morbidity and mortality. Studies have noted that patients who have advanced CKD such as in dialysis patients are at an even higher risk compared with CKD patients not on dialysis. Our retrospective study shows that the increased risk of mortality after TAVR in CKD patients begins at CKD3b or at an eGFR of 45 mL/min. These results emphasize the importance of risk stratifying these patients prior to obtaining a TAVR surgery, paying particularly special attention to those who have CKD3b.