Contrast induced nephropathy after transcatheter aortic valve implantation

Abstract

Background: Aortic stenosis ranks the third in the structure of all cardiovascular diseases, conceding only to arterial hypertension and coronary heart disease. Transcatheter aortic valve implantation (TAVI) is a promising area of interventional endovascular surgery that enables to provide surgical care to a significant group of the patients with severe aortal stenosis.

Aim: To assess the efficacy of prevention of the contrast induced nephropathy (CIN) in patients who underwent TAVI under general anesthesia.

Materials and methods: We evaluated incidence of CIN in 19 patients who underwent surgery for aortic valve stenosis under general anesthesia with hemodilution and intravenous magnesium sulfate 1 g before administration of the contrast.

Results: Laboratory signs of nephropathy within the first 72 hours after the intervention were found in 8/19 (42.1%) of patients. In 4 (50%) of patients with CIN, its risk had been very high, in 3 (38%), high, and in 1 (12%), moderate. The results obtained are compatible with the contrast-induced acute kidney injury risk estimated from the Mehran-Barrett-Parfrey scale.

Conclusion: The used technique of hemodilution and magnesium-based prevention can be considered a safe method of CIN prophylaxis in TAVI patients.

About the authors

D. L. Kranin

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, PhD, Head of Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

V. V. Stets

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, Head of Center of Anesthesiology and Intensive Care

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

O. R. Pestovskaya

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, PhD, Head of Center of Functional Diagnostics

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

E. P. Dunaev

Burdenko Main Military Clinical Hospital

Author for correspondence.
Email: drdunaevep@yandex.ru

MD, Anesthesiologist, Сardiosurgical Intensive Care Unit, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation. Tel.: +7 (499) 263 53 44

Russian Federation

D. A. Nazarov

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, PhD, Senior Registrar, Department of Сardiac Surgery, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

A. V. Gaydukov

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, PhD, Head of Interventional and Diagnostic Radiology Department, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

G. V. Mashtanov

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, Head of Сardiosurgical Intensive Care Unit, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

K. S. Zamskiy

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, PhD, Department of Vascular Surgery, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

A. Yu. Fedorov

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, PhD, Head of Operation Department, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

K. A. Varochkin

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, Registrar, Department of Сardiac Surgery, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

S. A. Kurnosov

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

MD, Registrar, Department of Сardiac Surgery, Center of Cardiovascular Surgery

3 Gospital'naya ploshchad', Moscow, 105229, Russian Federation

Russian Federation

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Copyright (c) 2017 Kranin D.L., Stets V.V., Pestovskaya O.R., Dunaev E.P., Nazarov D.A., Gaydukov A.V., Mashtanov G.V., Zamskiy K.S., Fedorov A.Y., Varochkin K.A., Kurnosov S.A.

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