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December 1, 2011European Journal of Cardio-Thoracic SurgeryOpen Access

Transcranial Doppler-detected cerebral embolic load during transcatheter aortic valve implantation

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Why the study?

Does access route or deployment technique affect the cerebral embolic load (HITS) during TAVI in high-risk patients with severe aortic stenosis?

Population

44 high-risk patients with severe aortic valve stenosis undergoing TAVI

Comparison

Transcatheter aortic valve implantation using… vs Comparisons between transfemoral vs transapical…

Design

Cohort

Follow-up

up to 30 days

Authors

GEGabor ErdoesHospital Central da Polícia MilitarRBReto BascianiKantonsspital AarauCHChristoph HuberGoethe University Frankfurt

Discussion

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Member takes

Implication

Self-expanding valves linked to higher HITS in TAVI; hypothesis-generating and should not yet change valve selection.

Structured PICO

Does access route or deployment technique affect the cerebral embolic load (HITS) during TAVI in high-risk patients with severe aortic stenosis?

P
Population
44 high-risk patients with severe aortic valve stenosis undergoing TAVI (age 78 ± 6 years; logistic EuroSCORE 28 ± 15%)
I
Intervention
Transcatheter aortic valve implantation (TAVI) using self-expanding (n=27) or balloon-expandable (n=17) valves via transfemoral (n=32) or transapical (n=12) access, monitored with Transcranial Doppler (TCD) ultrasound
C
Comparator
Comparisons between transfemoral vs transapical access, and self-expanding vs balloon-expandable deployment techniques
O
Outcome
Frequency of high-intensity transient signals (HITS) and differences in HITS pattern across procedural intervalssurrogate

Transcranial Doppler monitoring during TAVI reveals that cerebral embolic events occur in all patients, peaking during prosthesis deployment, with a higher embolic load observed with self-expanding compared to balloon-expandable valves.

Cite This Study

Erdoes et al. (2011) studied this question.

synapsesocial.com/papers/6a8201a2bbb70d3ba94cd97ahttps://doi.org/10.1093/ejcts/ezr068
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Transcatheter aortic valve implantation: predictors of procedural success—the Siegburg–Bern experience2009 · 103 citations
  2. 2Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis2002 · 3,195 citations
  3. 3The Effects of Cardiopulmonary Bypass on the Number of Cerebral Microemboli and the Incidence of Cognitive Dysfunction After Coronary Artery Bypass Graft Surgery2009 · 148 citations
  4. 4Stroke Complicating Percutaneous Coronary Interventions2002 · 212 citations
  5. 5Cerebral Embolism Following Transcatheter Aortic Valve Implantation2010 · 298 citations