The following is a summary of “Incidence and clinical impact of renal failure and bleeding following transcatheter tricuspid valve annuloplasty,” published in the February 2024 issue of Cardiology by Gietzen et al.
While bleeding commonly follows percutaneous leaflet-based tricuspid valve repair, increasing the risk of acute kidney injury (AKI) and poor outcomes, a detailed examination of this complication and its impact in the more complex Cardioband transcatheter tricuspid valve annuloplasty (TTVA) procedure is lacking.
Researchers conducted a retrospective study to assess the frequency and clinical significance of bleeding complications (assessed by MVARC criteria) and AKI (evaluated using KDIGO criteria) after TTVA.
They conducted a bi-center retrospective analysis on patients who underwent TTVA from 2018 to 2022, investigating the occurrence, predictors, and clinical ramifications of bleeding and renal failure.
The results showed that of 145 consecutive patients, 20.7% (n = 30) experienced any MVARC bleeding, with major MVARC bleeding occurring in 6.9% (n = 10). The incidence of AKI was 18.6% (n = 27). Risk factors for bleeding events included low baseline hemoglobin and elevated baseline creatinine levels. Risk factors for AKI included diabetes mellitus, arterial hypertension, high body mass index, and elevated baseline creatinine levels. Neither procedure duration nor amount of contrast media was associated with AKI or bleeding. Both bleeding and AKI resulted in a prolonged hospital stay. At the 3-month mark, 10.0% (n = 3) of patients experiencing bleeding complications and 7.8% (n = 9) of those without such complications died (P=0.70). The mortality rate stood at 7.4% (n = 2) among patients with AKI, compared to 8.5% (n = 10) in those without AKI (P=0.83).
Investigators concluded that one-fifth of patients receiving Cardioband TTVA experienced bleeding or AKI, but neither impacted short-term mortality, though pre-existing kidney issues increased risk. Careful management of potential bleeding sites like the femoral access and pericardium is crucial.
Source: link.springer.com/article/10.1007/s00392-024-02388-4