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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Related Experiment Video

Updated: Sep 29, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Stroke after transcatheter aortic valve replacement: A severe complication with low predictability.

Lena K Eschenbach1,2, Magdalena Erlebach1,2, Marcus-André Deutsch3

  • 1Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universität, München, Germany.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 21, 2022
PubMed
Summary

Stroke or transient ischemic attack (TIA) after transcatheter aortic valve replacement (TAVR) is a major complication. Prior stroke and initial procedural experience are key risk factors, significantly impacting 30-day survival.

Keywords:
cerebrovascular eventsneurological eventsrisk factorstransient ischemic attack

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Area of Science:

  • Cardiology
  • Neurology
  • Interventional Cardiology

Background:

  • Stroke and transient ischemic attacks (TIAs) are significant complications following transcatheter aortic valve replacement (TAVR).
  • Understanding the incidence and risk factors for post-TAVR stroke/TIA is crucial for improving patient outcomes.

Purpose of the Study:

  • To describe the occurrence of stroke and TIAs after TAVR.
  • To identify independent risk factors associated with stroke/TIA in the post-TAVR period.

Main Methods:

  • Retrospective analysis of prospectively collected data from 1919 patients undergoing TAVR between 2007 and 2017.
  • Stroke and TIA events were classified using Valve Academic Research Consortium-II criteria.
  • Logistic regression analysis was employed to determine independent risk factors for stroke/TIA.

Main Results:

  • The incidence of stroke/TIA was 3.9% (76 patients), with 1.9% disabling and 1.6% non-disabling events.
  • Prior stroke (OR=1.83) and the center's initial experience with TAVR (first 300 cases, OR=1.95) were identified as independent risk factors for stroke/TIA within 30 days.
  • Stroke occurrence significantly increased 30-day mortality (13.2% vs. 4.9% in patients without stroke, p=0.005).

Conclusions:

  • Stroke within 30 days post-TAVR substantially worsens 30-day survival.
  • Prior history of stroke and the learning curve associated with initial TAVR procedures are significant risk factors.
  • These findings highlight the importance of patient selection and procedural experience in mitigating stroke risk after TAVR.