TY - JOUR
T1 - A 91-year-old woman with severe aortic stenosis successfully underwent maintenance hemodialysis via arteriovenous fistula after transcatheter aortic valve implantation: A case report with literature review
AU - Yasukawa, Minoru
AU - Omizo, Hiroki
AU - Sakai, Kazuhiro
AU - Kitagawa, Sachiko
AU - Kikuyama, Takahiro
AU - Yamanaka, Masaki
AU - Ochiai, Fumika
AU - Togashi, Ryo
AU - Nemoto, Yoshikazu
AU - Ota, Tatsuya
AU - Kawashima, Hideyuki
AU - Takamura, Shintaro
AU - Watanabe, Yusuke
AU - Kozuma, Ken
AU - Shibata, Shigeru
AU - Fujigaki, Yoshihide
PY - 2019/12/16
Y1 - 2019/12/16
N2 - Background: Transcatheter aortic valve implantation (TAVI) has evolved to be a treatment of choice in high-risk patients with aortic stenosis (AS). However, it is not known whether TAVI is safe and beneficial for the creation of arteriovenous fistula for maintenance hemodialysis in high-risk patients with severe AS. Case presentation: A 91-year-old woman was referred to our hospital due to oligoanuria and progressive renal dysfunction. She was diagnosed with anti-glomerular basement membrane (GBM) disease. She had hypertension, chronic kidney disease stage G3b, and AS. We chose not to perform immunosuppressive therapy and plasmapheresis for anti-GBM disease because the risk of death outweighed the benefit of treatment. Hemodialysis with a venous catheter was initiated for the renal indication. As she showed severe AS, she had a risk of cardiac decompensation after arteriovenous fistula creation for dialysis. Following the clinical decision-making process, she underwent TAVI. Although she required the implantation of a cardiac pacemaker for an advanced atrioventricular block that occurred 11 days after TAVI, arteriovenous fistula was successfully created thereafter. She could undergo maintenance hemodialysis using arteriovenous fistula. Conclusions: TAVI is safe and beneficial for the creation of arteriovenous fistula shortly after initiating acute hemodialysis using a catheter in a very old patient with anti-GBM disease.
AB - Background: Transcatheter aortic valve implantation (TAVI) has evolved to be a treatment of choice in high-risk patients with aortic stenosis (AS). However, it is not known whether TAVI is safe and beneficial for the creation of arteriovenous fistula for maintenance hemodialysis in high-risk patients with severe AS. Case presentation: A 91-year-old woman was referred to our hospital due to oligoanuria and progressive renal dysfunction. She was diagnosed with anti-glomerular basement membrane (GBM) disease. She had hypertension, chronic kidney disease stage G3b, and AS. We chose not to perform immunosuppressive therapy and plasmapheresis for anti-GBM disease because the risk of death outweighed the benefit of treatment. Hemodialysis with a venous catheter was initiated for the renal indication. As she showed severe AS, she had a risk of cardiac decompensation after arteriovenous fistula creation for dialysis. Following the clinical decision-making process, she underwent TAVI. Although she required the implantation of a cardiac pacemaker for an advanced atrioventricular block that occurred 11 days after TAVI, arteriovenous fistula was successfully created thereafter. She could undergo maintenance hemodialysis using arteriovenous fistula. Conclusions: TAVI is safe and beneficial for the creation of arteriovenous fistula shortly after initiating acute hemodialysis using a catheter in a very old patient with anti-GBM disease.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85084388708&origin=inward
U2 - https://doi.org/10.1186/s41100-019-0247-2
DO - https://doi.org/10.1186/s41100-019-0247-2
M3 - Review article
SN - 2059-1381
VL - 5
JO - Renal Replacement Therapy
JF - Renal Replacement Therapy
IS - 1
M1 - 52
ER -