Prognostic Impact of Acute Kidney Injury Following Tricuspid Transcatheter Edge-to-Edge Repair

Tricuspid failure (TF) mostly affects the elderly and, because of this, is associated with comorbidities that increase surgical risk. 

La insuficiencia renal post tratamiento borde a borde tricuspídeo impacta en el pronóstico

Tricuspid edge to edge repair (TEER) has surged as a valid alternative for the mitral valve in high-risk patients and, at present, is increasingly being used for tricuspids. 

One of the complications following TEER is acute kidney injury (AKI), which in case of edge-to-edge repair happens in 1 every 6 patients and has prognostic impact. 

This complication has not yet been well assessed for right atrioventricular valves undergoing TEER. 

This is a retrospective registry of two centers in Germany including 268 patients with TF undergoing TEER with MitraClip, TriClip or Pascal. 42 of these patients presented AKI (15.7%). 

Primary end point was all cause mortality and hospitalization for cardiac failure at 12 months. 

Read also: Safety and Efficacy of Ticagrelor Monotherapy According to BMI.

The populations were similar: mean age was 79, 25% were diabetic, 82% hypertensive, 42% had CAD, 23% MI, 21% CABG, 11% stroke, 88% atrial fibrillation and NT-proBNP 2.022 pg/mL.

Patients presenting AKI were older (81 vs. 78 p=0.01), proportionally more were men (64.3% vs. 39,4% p=0.003), they had lower glomerular filtration 44.8 vs 51.4 (p=0.088) and higher EuroScore (7.98 vs. 4.9 p=0.003).

They had complete medical treatment. 

Read also: The New Sirolimus Eluting Balloons Are Also Effective.

Most procedures were done under general anesthesia. The most common device was MitraClip/TriClip, device failure was 5.6% and procedural success was 88.4%. Patients presenting AKI saw lower procedural success (79.3 vs. 90.6% p=0.03). 

Hospital mortality was higher in patients presenting AKI (9.5% vs. 0.9% p=0.006) as was bleeding and longer hospital stay. 

Primary end point at 12 months was higher among patients presenting AKI (66.2% vs 28.1%; P < 0.001).

AKI predictors were age, male sex, eGFR, left ventricular ejection fraction and procedural success. 

Conclusion

Acute kidney injury occurred in 15.7% of patients undergoing tricuspid transcatheter edge to edge repair despite no use of iodinated contrast agents. This situation was associated with worse evolution. 

These findings manifest the impact of acute kidney injury after transcatheter edge to edge repair of the tricuspid valve and should help identify patients at risk of acute kidney injury. 

Dr. Carlos Fava - Consejo Editorial SOLACI

Dr. Carlos Fava.
Member of the Editorial Board of SOLACI.org.

Original Title: Acute Kidney Injury Following Tricuspid  Transcatheter Edge-to-Edge Repair. 

Reference: Tetsu Tanaka, et al. J Am Coll Cardiol Intv 2022;15:1936–1945.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

TAVR in Small Annuli: What Valve Should We Use?

One of the major challenges of severe aortic stenosis are patients with small aortic annuli, defined as ≤430 mm² aortic valve area. This condition...

ACC 2025 | TAVI in Low-Risk Patients: 5-Year Outcomes of EVOLUTE LOW RISK

Transcatheter aortic valve implantation (TAVI) is a valid alternative to surgery in low-risk patients with severe aortic stenosis. However, one of its main limitations...

ACC 2025 | BHF PROTECT-TAVI: Are Cerebral Protection Systems Necessary in TAVI?

TAVI has seen a steady increase in use, though stroke continues to be one of its unwanted complications, mostly ischemic and, less frequently, hemorrhagic. The...

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

RACE Trial: Effect of Balloon Pulmonary Angioplasty and Riociguat on Right Ventricular Afterload and Function in Chronic Thromboembolic Pulmonary Hypertension

Even though pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), up to 40% of patients are not candidates because...

iFR- vs. FFR-Guided Coronary Revascularization: 5-Year Clinical Outcomes

The assessment of coronary stenosis using coronary physiology has become a key tool in guiding revascularization. The two most widely used techniques are fractional...

TAVR in Small Annuli: What Valve Should We Use?

One of the major challenges of severe aortic stenosis are patients with small aortic annuli, defined as ≤430 mm² aortic valve area. This condition...