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Transcatheter aortic valve implantation (TAVI) is a common treatment for aortic stenosis. Stroke is a feared complication, and this review explores its causes, risks, and neuroprotective strategies, including embolic protection.

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Area of Science:

  • Cardiology
  • Neurology
  • Interventional Cardiology

Background:

  • Aortic stenosis (AS) is a prevalent valvular heart disease requiring treatment.
  • Transcatheter aortic valve implantation (TAVI) is increasingly used for severe AS, expanding to lower-risk patients.
  • Periprocedural stroke is a significant complication of TAVI, impacting mortality and patient outcomes.

Purpose of the Study:

  • To provide a comprehensive overview of stroke in TAVI patients.
  • To discuss the incidence, trends, mechanisms, etiologies, and risk factors of TAVI-related stroke.
  • To suggest neuroprotective strategies and the role of embolic protection during TAVI.

Main Methods:

  • Review of contemporary literature on TAVI and stroke.
  • Analysis of definitions, incidence, and temporal trends of stroke.
  • Exploration of mechanisms, etiologies, and risk factors for neurological events.

Main Results:

  • Stroke is a major concern following TAVI, associated with increased mortality and disability.
  • Even subclinical ischemic lesions are common post-TAVI and may affect neurocognitive function.
  • The review synthesizes current knowledge on TAVI-associated stroke and preventative measures.

Conclusions:

  • Understanding TAVI-related stroke is crucial given the procedure's growing popularity.
  • Implementing neuroprotective strategies throughout the TAVI pathway is essential.
  • Embolic protective devices may play a key role in mitigating stroke risk during TAVI.