PROTECTED TAVR – Cerebral embolic protection?

PROTECTED TAVR – Cerebral embolic protection? Higher rates of stroke have been considered as a limitation of transcatheter aortic valve replacement (TAVR) in comparison with surgical aortic valve replacement (SAVR) [1,2]. Stroke following TAVR has been shown to increase the 30 day mortality from 3.7% to 16.7% according to a retrospective report from Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry. The registry had 101 430 patients who were treated with femoral and non-femoral TAVR at 521 US hospitals between 2011 and 2017 [3]. A previous study had used cerebral embolic protection device in 280 of the 802 consecutively enrolled TAVR patients. The use of cerebral embolic protection reduced the rate of disabling and non-disabling stroke from 4.6% to 1.4%. The analysis was by a propensity score matching to account for possible confounders [4]. PROTECTED TAVR trial enrolled 3000 patients across North America, Europe, and Australia. A cerebral embolic protection device was successfully deployed in 1406 of the 1489 patients (94.4%) in whom it was attempted [5]. The incidence of stroke within 72 hours of TAVR or before discharge was not significantly different between those who received the cerebral embolic protection device and those who did not (2.3% vs 2.9%). Disabling stroke occurred in 0.5% of the cerebral embolic protection group and in 1.3% of the control group. There was no significant difference in the mortality, trans...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions General Cardiology Structural Heart Disease Interventions Source Type: blogs