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Cerebral Embolic Protection Devices During TAVI

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Textbook of Catheter-Based Cardiovascular Interventions

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Abstract

Stroke after transcatheter aortic valve implantation (TAVI) remains a critical procedural complication that is associated with increased morbidity and mortality. MRI studies have shown new ischemic lesions in almost all TAVI patients; however, only a minority of these lesions manifest in acute clinical symptoms. These so-called “silent infarcts” may affect neurocognitive function and increase the risk for future clinical strokes: Prior injuries may make the brain more vulnerable to developing clinical strokes and may accelerate the risk of dementia. More than half of all clinical strokes after TAVI occur within 48 h. Embolic protection devices are designed to protect the brain from per-procedural cerebral embolization during endovascular procedures; however, in TAVI its clinical benefit remains to be explored. Strokes more than 48 h after TAVI seem to be related to pre-existing or new-onset atrial fibrillation. Oral anticoagulation regimens may affect events related to new-onset atrial fibrillation post-TAVI. Several trials are underway evaluating the role of oral anticoagulation post-TAVI.

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Authors and Affiliations

  1. Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands

    Zouhair Rahhab MD & Nicolas M. Van Mieghem MD, PhD

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  1. Zouhair Rahhab MD
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  2. Nicolas M. Van Mieghem MD, PhD
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Correspondence to Nicolas M. Van Mieghem MD, PhD .

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  1. Middle German Heart Center and Health Care Center Bitterfeld-Wolfen, gGmbH, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Rahhab, Z., Van Mieghem, N.M. (2018). Cerebral Embolic Protection Devices During TAVI. In: Lanzer, P. (eds) Textbook of Catheter-Based Cardiovascular Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-55994-0_100

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  • DOI: https://doi.org/10.1007/978-3-319-55994-0_100

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