Transcatheter aortic valve implantation (TAVI) has emerged as an alternative for patients with severe symptomatic aortic stenosis who are inoperable or at high risk for surgical aortic valve replacement (Gilard et al., 2012; Smith et al., 2011). TAVI requires prior assessment with Conventional Coronary Angiography (CCA) and Multidetector Computed Tomography (MDCT), both exposing patients to parenteral iodinated contrast media (CM) (Achenbach et al., 2012; Holmes et al., 2012). Contrast Induced Acute Kidney Injury (CI-AKI) is a frequent complication with increased mortality following TAVI (Gebauer et...

Datasets from consecutive patients from April 2009 through September 2013 referred to MDCT and/or CCA for the purpose of TAVI evaluation were retrospectively analysed. Patients were included when not on dialysis and when serum creatinine (SCr) was available before the first CM examination (baseline) and at least every 48 hours during the evaluation period (EP, days between the first and the last CM examination or TAVI). CI-AKI was defined and staged as shown in Figure1 (Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work...

Datasets of 98 patients (mean age 81 years, 49 male, mean eGFR 59ml/min, HF=35, DM=37, mean CM amount 274ml, mean EP 6d) out of 207 were eligible for evaluation (16 patients were already on dialysis, in 6patients baseline SCr was not available and in 87 patients, SCr was not consistently available throughout the EP and the following 7days). CI-AKI occurred in 67 patients (68%), of whom 48 (72%) had stage 1, 13 (19%) had stage 2 and 6 (9%) had stage 3. CI-AKI was inversely...

Incidence of CI-AKI in TAVI candidates is high and it occurs mostly already before implantation. Moreover, 19% of patients with CI-AKI finally had no benefit because TAVI was not performed. Risk factors, especially pre-existing chronic kidney disease and amount of CM, should already be taken into account when considering evaluating for TAVI in order to prevent harmful examinations. Main limitation of our study is that we are not able to attribute the risk to either intraarterial application of CM, as in CCA and TAVI, or...

Achenbach, S., Delgado, V., Hausleiter, J., Schoenhagen, P., Min, J. K., & Leipsic, J. A. (2012). SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr, 6(6), 366-380. Gebauer, K., Diller, G. P., Kaleschke, G., Kerckhoff, G., Malyar, N., Meyborg, M., . . . Baumgartner, H. (2012). The risk of acute kidney injury and its impact on 30-day and long-term mortality after transcatheter aortic valve implantation. Int J Nephrol, 2012, 483748. Genereux, P.,...