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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

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Cerebrovascular accidents complicating transcatheter aortic valve implantation: frequency, timing and impact on

Stefan Stortecky1, Stephan Windecker, Thomas Pilgrim

  • 1Department of Cardiology, Swiss Cardiovascular Centre, Bern University Hospital, Bern, Switzerland.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|May 15, 2012
PubMed

Insights

Cerebrovascular accidents (CVA) after transcatheter aortic valve implantation (TAVI) occur early and significantly increase mortality. Multiple implantation attempts and chronic pulmonary disease are key predictors of CVA post-TAVI.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Interventional Cardiology

Background:

  • Transcatheter aortic valve implantation (TAVI) is a critical procedure for severe aortic stenosis.
  • Cerebrovascular accidents (CVA) are a significant complication following TAVI.
  • Understanding CVA frequency, timing, and impact is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence and timing of CVA after TAVI.
  • To assess the clinical outcomes of patients experiencing CVA within 30 days.
  • To identify predictors of periprocedural CVA in TAVI patients.

Main Methods:

  • Retrospective analysis of 389 high-risk patients undergoing TAVI (August 2007 - October 2011).
  • Evaluation of CVA occurrence within 30 days post-procedure.
  • Statistical analysis to identify independent predictors and impact on mortality.

Main Results:

  • 14 patients (3.6%) experienced CVA within 30 days; 74% occurred on day one.
  • CVA patients had higher all-cause (42.3% vs. 5.1%) and cardiovascular mortality (38.4% vs. 4.6%).
  • Independent predictors included repeated device attempts, chronic pulmonary disease, and low BMI.

Conclusions:

  • CVA after TAVI predominantly occur periprocedurally.
  • CVA significantly worsen prognosis within 30 days post-TAVI.
  • Identifying and mitigating risk factors like multiple implantation attempts is vital.
Abstract

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