Silent Cerebral Embolism After Transcatheter Aortic-Valve Implantation

Two studies from Germany show that it is common.

Transcatheter aortic-valve implantation (TAVI) is a new therapy approved in Europe for high-risk patients with aortic stenosis. The risk for stroke after TAVI appears similar to that after aortic-valve replacement (AVR) surgery, an observation that is being tested in an ongoing U.S. randomized trial. In the meantime, investigators in Germany have assessed the risks for silent and clinical cerebral ischemic events after TAVI in two case series.

In one study, 32 patients (mean age, 80) underwent TAVI: 22 with the balloon-expandable SAPIEN device and 10 with the self-expanding CoreValve device. Many patients had other potential sources of embolism (chronic atrial fibrillation in 6 patients, reduced left-atrial appendage peak velocity in 16, mod…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)