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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Contrast-Induced Encephalopathy Following Transcatheter Aortic Valve Replacement: A Case Series

Manish Vinayak1, Adham Ahmed2, Anoop N Koshy1,3

  • 1Department of Cardiology, Mount Sinai Fuster Heart, Mount Sinai Hospital, New York, New York.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 12, 2024
PubMed

Insights

Contrast-induced encephalopathy (CIE) is a rare reaction to iodine-contrast dye. This report details the management of three patients experiencing CIE after transcatheter aortic valve replacement, highlighting limited existing literature.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Contrast-induced encephalopathy (CIE) is an idiopathic neurological complication associated with iodine-contrast media.
  • While documented after coronary and carotid angiography, CIE following transcatheter aortic valve replacement (TAVR) is infrequently reported.
  • TAVR procedures commonly utilize iodinated contrast agents, posing a potential risk for CIE.

Observation:

  • Three patients developed symptoms consistent with CIE post-TAVR.
  • Clinical presentations included altered mental status, seizures, and focal neurological deficits.
  • Diagnostic workup ruled out other common causes of neurological decline.

Findings:

  • Multidisciplinary management strategies were employed for the three TAVR patients with CIE.
  • Treatment focused on supportive care and prompt recognition of the contrast-induced reaction.
  • Recovery patterns varied among the patients, with most showing improvement over time.

Implications:

  • This case series expands the understanding of CIE in the context of TAVR.
  • Highlights the need for heightened awareness and vigilance for CIE in patients undergoing TAVR.
  • Suggests the importance of a multidisciplinary approach for managing this rare complication.

Keywords:
aortic stenosisencephalopathystroketranscatheter aortic valve replacement

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