Can J Cardiol. 2026 Aug 3:S0828-282X(26)01052-4. doi: 10.1016/j.cjca.2026.07.370. Online ahead of print.
ABSTRACT
Previous reports have comprehensively assessed clinical outcomes of transcatheter (TAVR) and surgical aortic valve replacement (SAVR) in patients with chronic kidney disease (CKD), including those on dialysis. Some studies suggest better short-term outcomes with TAVR, including lower periprocedural mortality, acute-on-chronic kidney injury, bleeding, and shorter length of stay, but similar or worse long-term survival compared with SAVR. While clinical outcomes have been studied, comparative durability and risk of structural valve deterioration (SVD) between transcatheter and surgical bioprosthetic valves in dialysis patients remain poorly defined. The therapeutic approach for the treatment of aortic valve disease in patients with end-stage renal disease is clinically relevant as these patients have short life expectancy and often receive bioprosthetic valves that are at higher risk for accelerated SVD and failure. This review synthesizes current literature describing TAVR and SAVR valve durability in patients with end-stage renal disease, focusing on mechanisms of bioprosthetic SVD, outcomes associated with TAVR and SAVR, and explores strategies for lifelong management of aortic valve disease, including considerations for reintervention.
PMID:42546969 | DOI:10.1016/j.cjca.2026.07.370