Cerebral Embolic Protection in Transcatheter Aortic Valve Replacement

Overview

Journal Struct Heart

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2023 Jul 31

PMID 37520138

Authors

Mina Iskander

Yasser Jamil

John K Forrest

Mahesh V Madhavan

Raj Makkar

Martin B Leon

Alexandra Lansky

Yousif Ahmad

Affiliations

Soon will be listed here.

Abstract

Transcatheter aortic valve replacement (TAVR) is a treatment option for patients with symptomatic severe aortic stenosis across the entire spectrum of surgical risk. Recent trial data have led to the expansion of TAVR into lower-risk patients. With iterative technological advances and successive increases in procedural experience, the occurrence of complications following TAVR has declined. One of the most feared complications remains stroke, and patients consider stroke a worse outcome than death. There has therefore been great interest in strategies to mitigate the risk of stroke in patients undergoing TAVR. In this paper, we will discuss mechanisms and predictors of stroke after TAVR and describe the currently available cerebral embolic protection devices, including their design and relevant clinical studies pertaining to their use. We will also review the current overall evidence base for cerebral embolic protection during TAVR and ongoing randomized controlled trials. Finally, we will discuss our pragmatic recommendations for the use of cerebral embolic protection devices in patients undergoing TAVR.

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