title: Does contrast agent injection during trans-catheter aortic valve implantation negatively affect kidney function?
abstract: BACKGROUND
  Trans-catheter aortic valve implantation (TAVI) has recently emerged as an alternative to conventional surgery in high-risk surgical patients with haemodynamically significant aortic valve stenosis. However, patients referred for TAVI are usually elderly individuals (> 80 years) who frequently also suffer from renal impairment. Trans-catheter valve therapies require extensive use of contrast injections with a risk of nephrotoxicity.
  
  
  OBJECTIVE
  To evaluate post-TAVI renal function and to determine whether the exposure to contrast injections might cause reduced kidney function and contrast-induced nephropathy.
  
  
  METHODS
  From January 2009 to September 2010, TAVI was performed in 39 patients (26 women and 13 men). The mean age of the patients was 81.43 ± 7.39 years, and the mean volume of contrast material administered was 187.95 ± 91.34 mL. Serum creatinine and glomerular filtration rate (GFR, acc. to the MDRD formula) were estimated in all patients prior to and 1, 2, and 5-8 days after TAVI.
  
  
  RESULTS
  Two female patients died on postoperative day 1. Other patients did not show clinically significant reduction in renal function following the procedure (mean creatinine concentration 104.46 vs 99.77 vs 94.56 vs 93.64 mmol/L, NS and mean GFR 52.37 vs 56.63 vs 60.18 vs 61.34 mL/min/1.73 m², NS).
  
  
  CONCLUSIONS
  1. The TAVI procedure, which includes contrast injection does not seem to cause a clinically significant decrease of renal function. 2. None of our elderly patients with severe aortic valve stenosis, multiple co-morbidities, and pre- TAVI renal compromise developed contrast-induced nephropathy.
authors: Department of Cardiology and Interventional Angiology, Institute of Cardiology, Warsaw, Poland. epodolecka@interia.pl
authors: Ewa
authors: E
authors: Podolecka
authors: Zbigniew
authors: Z
authors: Chmielak
authors: Marcin
authors: M
authors: Demkow
authors: Piotr
authors: P
authors: Michałek
authors: Ewa
authors: E
authors: Księżycka-Majczyńska
authors: Stefania Lidia
authors: SL
authors: Chojnowska
authors: Tomasz
authors: T
authors: Hryniewiecki
authors: Krzysztof
authors: K
authors: Kuśmierski
authors: Zbigniew
authors: Z
authors: Juraszyński
authors: Katarzyna
authors: K
authors: Czerwińska
authors: Ewa
authors: E
authors: Sitkowska-Rysiak
authors: Janina
authors: J
authors: Stępińska
authors: Witold
authors: W
authors: Rużyłło
authors: Adam
authors: A
authors: Witkowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D051437:Renal Insufficiency / Q000139:chemically induced*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media