July 1, 2011Journal of Cardiac Surgery
Cerebral Embolic Exposure During Transfemoral and Transapical Transcatheter Aortic Valve Replacement
Why the study?
Does transfemoral TAVR compared to transapical TAVR alter cerebral embolic exposure in patients undergoing TAVR?
Population
28 patients undergoing transcatheter aortic valve replacement with Edwards SAPIEN valve, mean age 83.4…
Comparison
Transfemoral (TF) TAVR (n=18) vs Transapical (TA) TAVR (n=10)
Design
Cohort
Follow-up
intraoperative
Authors
Discussion
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Member takes
Implication
Similar HITS by TAVR access route should not change practice; leaves open whether targeted protection during wire manipulation reduces events.
Structured PICO
Does transfemoral TAVR compared to transapical TAVR alter cerebral embolic exposure in patients undergoing TAVR?
P
Population
28 patients undergoing transcatheter aortic valve replacement (TAVR) with Edwards SAPIEN valve, mean age 83.4 years, STS predicted risk of mortality score 11.7.
I
Intervention
Transfemoral (TF) TAVR (n=18)
C
Comparator
Transapical (TA) TAVR (n=10)
O
Outcome
Cerebral embolic events measured as total number of high intensity transient signals (HITS) detected by intraoperative transcranial Doppler (TCD)surrogate
Cerebral embolic exposure, as measured by transcranial Doppler HITS, is similar between transfemoral and transapical TAVR, with the highest exposure occurring during wire manipulation in the arch and valve insertion.
Cite This Study
Szeto et al. (2011) studied this question.