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Incidence, predictors, origin and prevention of early and late neurological events after transcatheter aortic valve implantation (TAVI): a comprehensive review of current data

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Abstract

Transcatheter aortic valve implantation (TAVI) is a novel treatment option for patients with severe, symptomatic aortic valve stenosis considered inoperable or at high risk for surgical aortic valve replacement. Despite rapid adoption of this technology into clinical application, however, recent randomized controlled clinical trials have raised safety concerns regarding an increased risk of neurological events with TAVI compared to both medical treatment and conventional, surgical aortic valve replacement. Moreover, neuro-imaging studies have revealed an even higher incidence of new, albeit clinically silent cerebral lesions as a surrogate for procedural embolization. In this article, we review currently available data on the incidence, timing, predictors, prognostic implications and potential mechanisms of neurological events after TAVI.

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Conflict of interest

Philipp Kahlert and Matthias Thielmann have received honoraria payment as clinical proctors for Edwards Lifesciences Inc. Holger Eggebrecht is a clinical proctor for Edwards Lifesciences Inc. and Medtronic CoreValve and has received honoraria payment from both companies. The other authors declare no conflict of interest regarding this review article.

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Authors and Affiliations

  1. Department of Cardiology, West-German Heart Center Essen, Essen University Hospital, University Duisburg-Essen, Hufelandstr.55, 45122, Essen, Germany

    Philipp Kahlert, Fadi Al-Rashid, Björn Plicht, Heike Hildebrandt, Polykarpos Patsalis, Karim El Chilali, Holger Eggebrecht, Thomas Konorza & Raimund Erbel

  2. Department of Thoracic and Cardiovascular Surgery, West-German Heart Center Essen, Essen University Hospital, University Duisburg-Essen, Essen, Germany

    Daniel Wendt, Matthias Thielmann & Heinz Jakob

  3. Clinic for Anaesthesiology and Intensive Care Medicine, Essen University Hospital, University Duisburg-Essen, Essen, Germany

    Lars Bergmann & Eva Kottenberg

  4. Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital, University Duisburg-Essen, Essen, Germany

    Marc Schlamann

  5. Cardioangiological Center Bethanien, Frankfurt, Germany

    Holger Eggebrecht

  6. Institute for Pathophysiology, Essen University Hospital, University Duisburg-Essen, Essen, Germany

    Gerd Heusch

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  1. Philipp Kahlert
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  2. Fadi Al-Rashid
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  12. Holger Eggebrecht
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Correspondence to Philipp Kahlert.

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Kahlert, P., Al-Rashid, F., Plicht, B. et al. Incidence, predictors, origin and prevention of early and late neurological events after transcatheter aortic valve implantation (TAVI): a comprehensive review of current data. J Thromb Thrombolysis 35, 436–449 (2013). https://doi.org/10.1007/s11239-012-0863-y

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