MO353: Extracorporeal Blood Purification of Complications After Aortic Valve Replacement. Surgical Aortic Valve Replacement Compared With Transcatheter Aortic Valve Replacement

Abstract

Abstract BACKGROUND AND AIMS Complications after cardiac surgery have serious negative consequences, prolonging the average ICU stay days and costs. Prevention and treatment of complications after aortic valve replacement is a serious problem. According to numerous authors, the incidence of complications after aortic valve replacement varies from 10 to >60% of cases. Development of complications is associated with a higher hospital mortality rate, the risk of infection and a more complex course of the disease. Advances in cardiac surgery have led to a reduction in the overall mortality associated with open-heart surgery; however, it can still exceed 40% among those patients who develop a postoperative complication and can reach 50% in patients requiring extracorporeal blood purification therapy. Impaired renal function or active infectious process has significant prognostic consequences, which are the cause of up to 40% of deaths. The aim of this work is to structure or compare complications in immediate postoperative period after aortic valve replacement by the surgical and transcatheter method. METHOD Retrospective analysis of 267 medical records. All patients in study were after aortic valve replacement, hospitalized in JSC NSCC Nur-Sultan, Kazakhstan, from 1 January 2020 to 31 October 2021. A total of 127 patients SAVR, 137 patients TAVR. Of those, 3 patients were excluded from the study due to chronic haemodialysis. Inclusion criteria: informed consent to participate in research. Age is>18 years old. Prosthetics of the aortic valve by the SAVR or TAVR methods. Treatment of postoperative complications by the extracorporeal blood purification methods. Exclusion criteria: refusal to participate in research. Age is <18 years old. Chronic dialysis. Active bleeding. The patients were divided into two groups: group 1—patients after aortic valve replacement by the TAVR method and group 2—patients after open surgery aortic valve—SAVR. Indications for extracorporeal blood purification methods: acute kidney injury (AKI), acute liver injury, the systemic inflammatory response syndrome (SIRS) and cytokine storm. RESULTS Period from 2020 to 2021. TAVR group—137 patients, male―65 (47.45%), female—72 (52.55%), the average age of patients was 69.2±11.16 years. In the SAVR group, there were 127 patients, of which male 43 (33.9%) and female 84 (66.1%), the average age was 47.04 ± 13.67 years. CONCLUSION Complications and mortality rate are more common after open surgery SAVR than after TAVR. Extracorporeal blood purification methods are required after an open valve replacement. Extracorporeal blood purification methods are an effective way to treat complications such as AKI and SIRS after aortic valve replacement.