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Ann N Y Acad Sci. 2012 Apr;1254:151-63. doi: 10.1111/j.1749-6632.2012.06477.x.

Transcatheter aortic valve implantation and cerebrovascular events: the current state of the art.

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1
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.

Abstract

Transcatheter aortic valve implantation (TAVI) has revolutionized the care of high-risk patients with severe calcific aortic stenosis. Those considered at high or prohibitive risk of major adverse outcomes with open surgical aortic valve replacement may now be offered an alternative less-invasive therapy. Despite the rapid evolution and clinical application of this new technology, recent studies have raised concerns about adverse cerebrovascular event rates in patients undergoing TAVI. In this review, we explore the current data both in relation to procedure-related silent cerebrovascular ischemic events, as well as clinically apparent stroke. The timing of neurological events and their prognostic implications are also examined. Finally, potential mechanisms of TAVI-related cerebrovascular injury are described, in addition to efforts to minimize their occurrence.

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