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Managing Stroke During Transcatheter Aortic Valve Replacement.

Florian Hecker1, Mani Arsalan1, Thomas Walther1

  • 1Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany.

Interventional Cardiology (London, England)
|March 29, 2018
PubMed
Summary
This summary is machine-generated.

Transcatheter aortic valve replacement (TAVR) is a common procedure, but strokes are a concern. This review examines the causes and management strategies for stroke during TAVR.

Keywords:
Transcatheter aortic valve replacementantiplateletantithromboticembolic protection deviceembolisationtranscatheter aortic valve implantationtransient ischaemic attack calcification

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Area of Science:

  • Cardiology
  • Neurology
  • Interventional Cardiology

Background:

  • Transcatheter aortic valve replacement (TAVR) is a primary treatment for severe aortic stenosis in high-risk patients and an alternative for intermediate-risk patients.
  • Concerns persist regarding stroke incidence following TAVR procedures.
  • Stroke rates after TAVR are variable, influenced by study design, definitions, and patient cohorts.

Purpose of the Study:

  • To review the distinct phases and etiologies of stroke occurring after TAVR.
  • To explore potential management strategies for mitigating stroke risk during TAVR.

Main Methods:

  • Literature review of studies investigating stroke in TAVR patients.
  • Analysis of stroke occurrence in relation to procedural timing (early, intermediate, late phases).
  • Synthesis of information on the diverse causes of post-TAVR stroke.

Main Results:

  • Stroke after TAVR manifests in three phases: immediate post-procedure, a 2-30 day interval, and a late phase.
  • Each phase is associated with specific etiological factors contributing to stroke.
  • Understanding these phases and causes is crucial for effective stroke management.

Conclusions:

  • Stroke is a significant complication of TAVR, with varied timing and causes.
  • Targeted strategies are needed to address the specific etiologies of stroke in each phase.
  • Further research into stroke prevention and management in TAVR is warranted.