title: Transcatheter aortic valve implantation in dialysis patients.
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option for high-risk patients. However, dialysis patients were excluded from all previous studies. The aim of this study is to compare the outcomes of TAVI for dialysis patients with those for patients with chronic kidney disease (CKD) stages 3 and 4 and to compare TAVI with open surgery in dialysis patients.
  
  
  METHODS
  Part I: comparison of 10 patients on chronic hemodialysis with 116 patients with non-dialysis-dependent CKD undergoing TAVI. Part II: comparison of transcatheter (n = 15) with open surgical (n = 24) aortic valve replacement in dialysis patients.
  
  
  RESULTS
  Part I: dialysis patients were significantly younger (72.3 vs. 82.0 years; p < 0.01). Hospital stay was significantly longer in dialysis patients (21.8 vs. 12.1 days; p = 0.01). Overall 30-day mortality was 3.17%, with no deaths among dialysis patients. Six-month survival rates were similar (log-rank p = 0.935). Part II: patient age was comparable (66.5 vs. 69.5 years; p = 0.42). Patients in the surgical group tended to stay longer in hospital than TAVI patients (29.5 vs. 22.5 days; p = 0.35).
  
  
  CONCLUSIONS
  TAVI is a safe procedure in patients on chronic hemodialysis. Until new data become available, we find no compelling reason to refuse these patients TAVI.
authors.affiliation: Schwerpunkt Nephrologie, Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität München, Klinikum Grosshadern, München, Deutschland. Simon.Rau@med.uni-muenchen.de
authors.forename: Simon
authors.initials: S
authors.lastname: Rau
authors.forename: Matthias
authors.initials: M
authors.lastname: Wessely
authors.forename: Philipp
authors.initials: P
authors.lastname: Lange
authors.forename: Christian
authors.initials: C
authors.lastname: Kupatt
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
authors.forename: Michael
authors.initials: M
authors.lastname: Fischereder
authors.forename: Ulf
authors.initials: U
authors.lastname: Schönermarck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000401:mortality*; D015897:Comorbidity; D003956:Dialysis / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data*; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000534:rehabilitation*; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome