In patients with Congestive Heart Failure (CHF), neurohormonal activation leads to fluid overload that can be treated with high doses of furosemide unless diuretic resistance and hyponatremia develop. End-stage CHF, including patients with normal or slightly deteriorated kidney function, can resist medical treatment. In some cases of refractory CHF, ultrafiltration (UF) is required. To manage a refractory CHF population, extracorporeal UF is commonly used as an emergency treatment, but peritoneal UF should be considered a follow-up therapy option. This method offers potential advantages over extracorporeal therapies, including better preservation of residual renal function, tighter control of sodium balance, less neurohumoral activation, and the possibility of daily treatment in the home environment. Using glucose as an osmotic agent leads to the deterioration of the peritoneal membrane. The UF properties of icodextrin depend on the dwell time, whereby the maximum effect of icodextrin concerning glucose is achieved at a prolonged dwell time. Icodextrin may offer improved peritoneal membrane biocompatibility compared with conventional glucose-based dialysates by decreasing glucose exposure, iso-osmolarity, and reduced carbonyl stress. The proper anesthesia technique and surgical approach for peritoneal dialysis (PD) catheter placement in CHF patients must be based on the patient’s characteristics, available equipment, and surgeon’s experience. An open procedure using a transversus abdominis plane block for PD catheter placement in patients with CHF is strongly recommended.

Background and Objectives: Conduction disorders (CDs) and permanent pacemaker implantation (PPI) remain among the most common complications after transcatheter aortic valve implantation (TAVI). Given their potential impact on long-term outcomes, improved preprocedural identification of patients at high risk for new-onset CDs is increasingly important. We investigated whether selected preprocedural inflammatory and fibrotic biomarkers, along with echocardiographic indices of regional myocardial remodeling, were associated with new-onset CDs after TAVI. Materials and Methods: This single-center prospective observational study included 112 patients with severe aortic stenosis undergoing TAVI. Peripheral blood samples were obtained within 24 h before TAVI for measurement of inflammatory and fibrotic biomarkers, including interleukin-6 (IL-6), C-reactive protein (CRP), CRP-to-albumin ratio (CAR), procalcitonin, ferritin, lactate dehydrogenase, and transforming growth factor-β1. The primary outcome was the occurrence of new-onset CDs during the index hospitalization or within three months after TAVI. Results: New-onset CDs occurred in 58 patients (51.8%). IL-6 showed the strongest association with the outcome in univariable analysis (OR per 1-SD increase, 9.55; 95% CI 3.00–30.40; p < 0.001), remained associated after adjustment for selected clinical and procedural predictors in exploratory models (adjusted OR 10.70; 95% CI 2.43–47.07; p = 0.002), and demonstrated the highest, although moderate, discriminatory performance among the evaluated biomarkers (AUC 0.730; 95% CI 0.637–0.823). CRP and CAR were higher in patients with CDs and were significant in univariable analysis, but showed weaker and less consistent adjusted associations. Among echocardiographic markers, AB strain ratio ≥ 2 was the most consistent imaging correlate in exploratory biomarker–echocardiographic models. Conclusions: Elevated preprocedural IL-6 was the biomarker most consistently associated with new-onset CDs after TAVI. These findings suggest that higher preprocedural IL-6 levels may reflect patient-specific susceptibility to new-onset CDs after TAVI and could have potential value as an adjunctive biomarker, alongside echocardiographic assessment, for preprocedural risk evaluation, with further validation required in larger prospective studies.