Full Body Embolic Protection During Transcatheter Aortic Valve Replacement in High Risk Patients

Stroke remains one of the most feared complications of transcatheter aortic valve replacement (TAVR). We report our initial experience using a dedicated full-body embolic protection device during TAVR in 3 patients with severe aortic stenosis and high-risk embolic features. This included large thrombus on the aortic valve, a left ventricular outflow tract mass, and persistent left atrial thrombus despite anticoagulation. Device deployment and retrieval were successful in all procedures, with no device-related complications or neurologic events at 30-day follow-up. Macroscopic debris was retrieved in 2 patients, and histopathologic analysis in 1 case demonstrated atheromatous plaque components. This initial experience demonstrates the feasibility of full-body embolic protection in selected patients with high-risk undergoing TAVR and supports further evaluation in prospective studies.