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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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C. Arrhythmias and Device Therapy
D. Heart Failure
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Impact of Transcatheter Aortic Valve Implantation on Kidney Function in Chronic Kidney Disease patients
Session:
Posters (Sessão 5 - Écran 5) - Intervenção Valvular Aórtica Percutânea 2
Speaker:
Ana Débora Câmara de Sá
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Débora Câmara De Sá; Francisco Sousa; Margarida Temtem; Ricardo Rodrigues; Graça Caires; Digo Rijo; João Adriano Sousa; Sónia Freitas; João Manuel Rodrigues; António Drumond Freitas; Bruno Silva
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="background-color:white"><span style="color:black">Background:</span></span></strong><span style="background-color:white"><span style="color:black"> Transcatheter aortic valve implantation (TAVI) has been established as an alternative procedure for patients with symptomatic severe aortic stenosis. Procedural steps of TAVI, including contrast use may damage kidney function, especially in patients with established chronic kidney disease (CKD). However, there is a theorical increase in cardiac output after TAVI, that can eventually improve renal blood flow and kidney function. Data describing kidney function trends after TAVI in patients with CKD are lacking. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="background-color:white"><span style="color:black">Purpose:</span></span></strong><span style="background-color:white"><span style="color:black"> Analyze the impact of TAVI on kidney function in CKD patients. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="background-color:white"><span style="color:black">Methods:</span></span></strong><span style="background-color:white"><span style="color:black"> We performed a retrospective study of 143 consecutive patients who underwent TAVI </span></span>in a single center <span style="background-color:white"><span style="color:black">between february 2018 and november 2022. Creatinine Clearance (CrCl) were calculated according to the </span></span>Cockcroft-Gault<span style="background-color:white"><span style="color:black"> equation and patient with CrCl<60ml/min were selected. Subanalysis of patient with moderate to severe and severe CKD (CrCl<30ml/min) was performed. Patients undergoing dialysis were excluded (5 patients). CrCl were analyzed at baseline (before TAVI) and at time of discharge. Paired sample T test were used for statistical analysis.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="background-color:white"><span style="color:black">Results</span></span></strong><span style="background-color:white"><span style="color:black">: A total of 103 patients (72%) had CKD (mean age is 82.6</span></span> <span style="background-color:white"><span style="color:black">± 4.9 years, 30.1% males). Mean CrCl at baseline was 40.7 ± 12.5 ml/min, and at time of discharge 44.8 ± 17.7 ml/min (<em>p</em> < 0.001). Globally, CrCl went up in 73 patients, lowered in 28, and stayed equal in 2 patients (<em>p</em> < 0.001). The median hospitalization time was 3 days (IQR 3). </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="color:black">Twenty patients had moderate to severe and severe CKD (mean age is 84.2</span></span> <span style="background-color:white"><span style="color:black">± 5.3 years, 15% males). Mean CrCl was 22.5 ± 7.6 ml/min at baseline and 25.3 ± 12.7 ml/min at time of discharge (<em>p</em> < 0.001).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="background-color:white"><span style="color:black">Conclusion:</span></span></strong><span style="background-color:white"><span style="color:black"> In a population with CKD submitted to TAVI the CrCl improved significantly at discharge, despite administration of iodine contrast. This benefit is still present in patient with more severe CKD. This outcome is probably due to post-TAVI hemodynamic changes with better kidney perfusion. </span></span></span></span></p>
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