Low Contrast Strategies in TAVR: Feasibility and Outcomes to Prevent Renal Injury in Chronic Kidney Disease

• DOI: 10.1002/ccd.31490
• Publication Date: 2025-03-17T07:42:57Z
• Authors: Brigitte Kazzi; David I. Blusztein; Chunhui Wang; Yuming Ning; Tamim Nazif; Rebecca T. Hahn; Martin Leon; Paul A. Kurlansky; Susheel Kodali; Isaac George
• Keywords: Renal replacement therapy; Clinical endpoint

ABSTRACT Background Contrast volume is a major risk factor for acute kidney injury (AKI) in patients with chronic disease (CKD) after TAVR. Use of low‐contrast (LC) protocol TAVR may reduce AKI without impacting other clinical outcomes. Methods Stage 3b or worse CKD between 2015 and 2020 were grouped into LC normal‐contrast (NC). was defined as procedure contrast use (mL) less than estimated glomerular filtration rate (eGFR, mL/min/1.73 m 2 ). The primary outcome AKI, creatinine elevation > 200% ≥ 0.3 mg/dL from baseline. Secondary outcomes 30‐day mortality, length stay, paravalvular leak at 30 days, new dialysis requirement, vascular complication, re‐admission, bleeding, composite endpoint secondary We performed propensity‐matched analysis, compared cohort outcomes, stratified by severity. Results Four hundred thirty‐seven analyzed. group ( n = 173) more commonly male had lower baseline eGFR (31 vs. 33, p 0.03) the NC 264). After propensity‐matching, occurred frequently (17.9 28.3%, 0.0217). There no inter‐group differences complications, re‐admissions. Conclusions In CKD, associated reduced supporting approach patients. Aims sought to evaluate versus dose strategy amongst CKD.