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.