Key result
This review provides an overview of the incidence, pathophysiological mechanisms, impact on outcomes, and preventive strategies for cerebrovascular events complicating transcatheter aortic valve implantation.
Why the study?
What are the incidence, mechanisms, outcomes, and preventive strategies for cerebrovascular accidents complicating transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis?
What are the incidence, mechanisms, outcomes, and preventive strategies for cerebrovascular accidents complicating transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis?
This review highlights the incidence, mechanisms, and management of cerebrovascular accidents as a critical complication of TAVI that can negate its clinical benefits.
Highlights cerebrovascular risk as a major TAVI limitation; leaves open optimal preventive strategies pending further trials.
Transcatheter aortic valve implantation (TAVI) is an evidence-based treatment alternative for selected high-risk patients with symptomatic severe aortic stenosis as acknowledged in the most recent edition of the ESC Guidelines on Valvular Heart Disease 2012. However, periprocedural complications and in particular cerebrovascular accidents remain a matter of concern. While transcatheter heart valve technology continuously improves and the development of novel and even less invasive implantation techniques is on-going, cerebrovascular events complicating TAVI may abrogate the usual improvement in terms of prognosis and quality of life. This article describes the incidence of cerebrovascular events after cardiovascular procedures, provides an overview of the pathophysiological mechanisms as well as the impact on outcomes and provides some insights into preventive strategies as well as the acute management of these events.
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Stortecky et al. (2012) conducted a review in symptomatic severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) was evaluated on cerebrovascular events. This review provides an overview of the incidence, pathophysiological mechanisms, impact on outcomes, and preventive strategies for cerebrovascular events complicating transcatheter aortic valve implantation.
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