{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:49:30Z","timestamp":1792684170356,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with chronic hemodialysis due to end-stage renal disease (ESRD) or severely impaired kidney function (CKD) constitute a relevant share of patients undergoing trans-catheter aortic valve implantation (TAVI). However, data on specific challenges and outcomes remain limited.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>We aimed to characterize this patient population, evaluate clinical results and assess the significance of calcification patterns.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective single-center analysis evaluated 2,712 TAVI procedures (2012\u20132019) according to baseline renal function: GFR\u2009&lt;\u200930\u00a0ml\/min\/1.73m<jats:sup>2<\/jats:sup> (CKD; <jats:italic>n<\/jats:italic>\u2009=\u2009210), chronic hemodialysis (ESRD; <jats:italic>n<\/jats:italic>\u2009=\u2009119) and control (CTRL; <jats:italic>n<\/jats:italic>\u2009=\u20092383). Valvular and vascular calcification patterns were assessed from contrast-enhanced multi-detector computed tomography. Outcomes were evaluated in accordance with the VARC-2 definitions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Operative risk was higher in ESRD and CKD vs. CTRL (STS-score 8.4% and 7.6% vs. 3.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and patients with ESRD had more severe vascular calcifications (49.1% vs. 33.9% and 29.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Immediate procedural results were similar but non-procedure-related major\/life-threatening bleeding was higher in ESRD and CKD (5.0% and 5.3% vs. 1.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). 3-year survival was impaired in patients with ESRD and CKD (33.3% and 35.3% vs. 65.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Multivariable analysis identified ESRD (HR 1.60), CKD (HR 1.79) and vascular calcifications (HR 1.29) as predictors for 3-year and vascular calcifications (HR 1.51) for 30-day mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Patients with ESRD and CKD constitute a vulnerable patient group with extensive vascular calcifications. Immediate procedural results were largely unaffected by renal impairment, yielding TAVI a particularly valuable treatment option in these high-risk operative patients. Mid-term survival was determined by underlying renal disease, cardiovascular comorbidities, and vascular calcifications as a novel risk marker.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-021-01968-y","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T04:41:02Z","timestamp":1636778462000},"page":"1313-1324","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["End-stage renal disease, calcification patterns and clinical outcomes after TAVI"],"prefix":"10.1007","volume":"111","author":[{"given":"David","family":"Grundmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Linder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Go\u00dfling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Voigtl\u00e4nder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ludwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Waldschmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Demal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver D.","family":"Bhadra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Schirmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Reichenspurner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Schofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenard","family":"Conradi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3940-9079","authenticated-orcid":false,"given":"Moritz","family":"Seiffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"1968_CR1","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1161\/CIRCULATIONAHA.119.041080","volume":"140","author":"B Iung","year":"2019","unstructured":"Iung B, Delgado V, Rosenhek R et al (2019) Contemporary presentation and management of valvular heart disease: the EUrobservational research programme valvular heart disease II survey. 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Linder, L. Voigtl\u00e4nder, S. Ludwig and O.D. Bhadra have received travel compensation from Edwards Lifesciences. M. Seiffert served as consultant for JenaValve and Boston Scientific, has received travel compensation from Edwards Lifesciences, JenaValve, Boston Scientific and Biotronik, and has received speaker honoraria from Medtronic. N. Schofer has received travel compensation from Edwards Lifesciences and St. Jude Medical, as well as speaker honoraria and travel compensation from Boston Scientific. J. Schirmer is a proctor for Boston Scientific and JenaValve. L. Conradi is a proctor for and has received speaker honoraria as well as travel compensation from JenaValve, Edwards Lifesciences and Boston Scientific, has received speaker honoraria and travel compensation from Medtronic, and is a consultant for Edwards Lifesciences. D. Westermann has received honoraria from AstraZeneca, Bayer, B\u00f6hringer-Ingelheim, Berlin Chemie, Novartis and Medtronic. The other authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}