The Negative Effect of Mean Perfusion Pressure on the Development of Acute Kidney Injury after Transcatheter Aortic Valve Implantation

• Main Authors: Ilker Gül, Levent Cerit, Bihter Senturk, Mustafa Zungur, Mustafa Beyazıt Alkan, Hatice Kemal, Zeynep Cerit, Belma Yaman, Songul Usalp, Hamza Duygu
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cirurgia Cardiovascular
• Series: Brazilian Journal of Cardiovascular Surgery
• Subjects: Transcatheter Aortic Valve Replacement; Kidney; Acute Kidney Injury; Perfusion
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000600559&lng=en&tlng=en

Abstract Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development of acute kidney injury (AKIN) after transcatheter aortic valve implantation (TAVI). Methods: One hundred and forty seven consecutive patients with aortic stenosis (AS) were evaluated for this study and 133 of them were included. Mean arterial pressure (mAP) and central venous pressure (CVP) were used to calculate mPP before TAVI procedure (mPP = mAP-CVP). The occurrence of AKIN was evaluated with AKIN classification according to the Valve Academic Research Consortium-2 recommendations. The patients were divided into two groups according to the receiver operating characteristic (ROC) analysis of their mPP levels (high-risk group and low-risk group). Results: The AKIN prevalence was 22.6% in this study population. Baseline serum creatinine level, glomerular filtration rate, amount of contrast medium, and the level of mPP were determined as predictive factors for the development of AKIN. Conclusion: The occurrence of AKIN is associated with increased morbidity and mortality rates in patients with TAVI. In addition to the amount of contrast medium and basal kidney functions, our study showed that lower mPP was strongly associated with development of AKIN after TAVI.