Is Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement Beneficial?

Yes, according to a large observational study demonstrating a reduction in stroke and all-cause mortality.

Transcatheter aortic valve replacement (TAVR) is associated with stroke (≤5% of patients) and subclinical cerebral embolic lesions (≤70%). A filter-based embolic protection device was recently FDA approved, based on a randomized trial demonstrating nonsignificant reductions in new cerebral lesion volumes and stroke. However, use of the device remains controversial owing to its costs and the trial's failure to reach its primary 30-day endpoint.

In the present single-center study, 280 patients successfully receiving embolic protection (91.8% of 305 consecutive patients) were compared with a propensity-score–matched cohort from among 522 consecutive patients treated without embolic protection just prior to the device's availability. At 7 days, …

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)