This article is more than 5 years old. Information may no longer be current.

TAVI associated with high rate of cerebral ischemic lesions

Rodés-Cabau J. J Am Coll Cardiol. 2011;57:18-28.

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Patients undergoing transcatheter aortic valve implantation had a high rate of silent cerebral ischemic lesions, an association that did not change for either transapical or transfemoral approaches, according to new data.

The prospective, multicenter study featured patients (n=60) undergoing transcatheter aortic valve implantation (TAVI; Sapien or Sapien XT valve, Edwards Lifesciences) — 29 with the transfemoral and 31 with the transapical approach — at two Canadian institutions. Researchers performed diffusion-weighted MRI the day before and within 6 days after TAVI.

Successful implantation was achieved in all but one of the procedures. Forty-one (68%) patients had 251 new cerebral ischemic lesions after the procedure (median number of three lesions per patient); 19 of these patients in the transfemoral arm and 22 in the transapical arm (P=.78 for the trend). In addition, lesion number and size did not differ between approaches. Researchers also found no association between measurable impairment in cognitive function and the occurrence of cerebral embolism.

The lack of difference between both approaches, the researchers wrote, “suggests that the mechanical stress of the aortic valve during balloon valvuloplasty/valve implantation and the occurrence of gaseous embolism might be the main mechanisms linking the transfemoral and transapical TAVI procedures to cerebral embolism. However, no predictive factors of cerebral embolism were found, reflecting the complexity of evaluating the mechanisms, which are probably multifactorial, of cerebral embolism in these procedures.”

Future research, they said, is needed to improve the profile and reduce the size of TAVI catheters and evaluate the efficacy of using protection systems for cerebral circulation during TAVI.

Follow CardiologyToday.com on Twitter.