Preventing or Minimizing Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement

J Invasive Cardiol. 2021 Jan;33(1):E32-E39.

Abstract

Transcatheter aortic valve implantation (TAVI) is now routinely performed in patients with aortic stenosis with low mortality and complication rates. Although periprocedural risks have been substantially minimized, procedure- and contrast-induced acute kidney injury (AKI) remains a major concern. AKI remains a frequent complication of contrast-guided interventional procedures and is associated with a significantly adverse prognosis. We review the currently available clinical data related to AKI, with emphasis on contrast-induced nephropathy (CIN), and discuss a novel, integrated approach aiming to minimize AKI risk in high-risk patients. A stepwise algorithm is also proposed for the management of these complex patients.

Keywords: acute kidney injury; aortic stenosis; contrast-induced nephropathy; double J-tip wire; transcatheter aortic valve replacement.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / epidemiology
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / diagnosis
  • Aortic Valve Stenosis* / surgery
  • Humans
  • Prognosis
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects