Outcomes of Hemodialysis Patients Undergoing Contemporary Transcatheter Aortic Valve Implantation ― Insights From the LAPLACE-TAVI Registry ―
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement in hemodialysis patients; however, contemporary outcomes and risk stratifications remain unreported. METHODS AND RESULTS: Using data from a multicenter database, this study included 2,888 patients who underwent TAVI between 2021 and 2024: 336 (11.6%) on hemodialysis and 2,552 (88.4%) not. The primary outcome was all-cause death after TAVI; the median follow-up was 527 days. Hemodialysis patients were younger, predominantly male, and had more comorbidities with higher surgical risk. Hemodialysis and non-hemodialysis patients had similar 30-day mortality (2.9% vs. 1.5%, respectively) and major procedural complications. Hemodialysis patients had 2- to 3-fold higher rates of all-cause death (14.4% vs. 6.5% at 1-year; 21.5% vs. 11.0% at 2 years), cardiovascular death, and the composite of all-cause death and heart failure hospitalization. After adjusting for confounders, hemodialysis had no significant effect on all-cause death and the composite endpoint. Body mass index, Clinical Frailty Scale, and albumin levels were associated with all-cause death in hemodialysis patients, allowing risk stratification into low-, intermediate-, and high-risk groups. CONCLUSIONS: In this study, hemodialysis patients were younger and had more comorbidities, but 30-day mortality and complications were similar to the non-hemodialysis group. Although hemodialysis patients had higher all-cause mortality, the worse outcomes in this group were attributed to comorbidities rather than the hemodialysis itself.
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BibTeX
@article{higuchi2026outcomes,
title = {{Outcomes of Hemodialysis Patients Undergoing Contemporary Transcatheter Aortic Valve Implantation ― Insights From the LAPLACE-TAVI Registry ―}},
author = {Ryosuke Higuchi and Shuro Narui and Itaru Takamisawa and Mamoru Nanasato and Shinichiro Doi and Shinya Okazaki and Harutoshi Tamura and Masaki Ishiyama and Hiroaki Yokoyama and Motoki Fukutomi and Shuichiro Takanashi and Mike Saji and Mitsuaki Isobe},
journal = {Circulation Journal},
year = {2026},
month = aug,
doi = {10.1253/circj.cj-25-0500},
url = {https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0500/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Outcomes of Hemodialysis Patients Undergoing Contemporary Transcatheter Aortic Valve Implantation ― Insights From the LAPLACE-TAVI Registry ―
AU - Ryosuke Higuchi
AU - Shuro Narui
AU - Itaru Takamisawa
AU - Mamoru Nanasato
AU - Shinichiro Doi
AU - Shinya Okazaki
AU - Harutoshi Tamura
AU - Masaki Ishiyama
AU - Hiroaki Yokoyama
AU - Motoki Fukutomi
AU - Shuichiro Takanashi
AU - Mike Saji
AU - Mitsuaki Isobe
PY - 2026
DA - 2026/08/25
JO - Circulation Journal
DO - 10.1253/circj.cj-25-0500
UR - https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0500/_article
AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement in hemodialysis patients; however, contemporary outcomes and risk stratifications remain unreported. METHODS AND RESULTS: Using data from a multicenter database, this study included 2,888 patients who underwent TAVI between 2021 and 2024: 336 (11.6%) on hemodialysis and 2,552 (88.4%) not. The primary outcome was all-cause death after TAVI; the median follow-up was 527 days. Hemodialysis patients were younger, predominantly male, and had more comorbidities with higher surgical risk. Hemodialysis and non-hemodialysis patients had similar 30-day mortality (2.9% vs. 1.5%, respectively) and major procedural complications. Hemodialysis patients had 2- to 3-fold higher rates of all-cause death (14.4% vs. 6.5% at 1-year; 21.5% vs. 11.0% at 2 years), cardiovascular death, and the composite of all-cause death and heart failure hospitalization. After adjusting for confounders, hemodialysis had no significant effect on all-cause death and the composite endpoint. Body mass index, Clinical Frailty Scale, and albumin levels were associated with all-cause death in hemodialysis patients, allowing risk stratification into low-, intermediate-, and high-risk groups. CONCLUSIONS: In this study, hemodialysis patients were younger and had more comorbidities, but 30-day mortality and complications were similar to the non-hemodialysis group. Although hemodialysis patients had higher all-cause mortality, the worse outcomes in this group were attributed to comorbidities rather than the hemodialysis itself.
SN - 1347-4820
SN - 1346-9843
ER -