The Heart and the Head Neurological Implications of Transcatheter Aortic Valve Replacement ∗

In this issue of the Journal, Bosmans et al. (1) report much-awaited stroke outcomes from the ADVANCE study, a multicenter, prospective, nonrandomized cohort of patients undergoing transcatheter aortic valve replacement (TAVR) with the CoreValve prosthesis (Medtronic Inc., Minneapolis, Minnesota) at 44 mostly European sites between March 2010 and July 2011. In this real-world cohort of patients with severe aortic stenosis, the investigators observed stroke rates of 3.0% at 30 days post-TAVR and 5.6% at 2 years. They reported no significant predictors of periprocedural stroke or transient ischemic attack (TIA) occurring within the first postoperative day but demonstrated an association between acute kidney injury, female sex, or major vascular complication and 30-day stroke. The only predictor of long-term stroke was a prior coronary artery bypass grafting operation.
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research