Incidence and Clinical Impact of Stroke Complicating Transcatheter Aortic Valve Implantation: Results From the German TAVI Registry

Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective treatment for patients with severe, symptomatic aortic valve stenosis at high surgical risk over the last years. However, besides its minimal invasive character, TAVI still is an invasive procedure usually performed in a population, carrying a substantial risk for vascular complications, like stroke. Stroke is known to be a rare but serious complication of transvascular interventions in clinical practice, which is associated with high morbidity and mortality rates. Despite broad clinical research in many fields of TAVI over the last years, only sparse data still exist on the incidence and clinical risk factors of stroke complicating TAVI in clinical practice today.

[1]  L. Davidson,et al.  Stroke Prevention: Let's Prepare for Generation X TAVR , 2016, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[2]  S. Blankenberg,et al.  Transfemoral TAVI without pre-dilatation using balloon-expandable devices: a case-matched analysis , 2015, Clinical Research in Cardiology.

[3]  P. Scisło,et al.  Direct transcatheter aortic valve implantation – one-year outcome of a case control study , 2014, Postepy w kardiologii interwencyjnej = Advances in interventional cardiology.

[4]  J. Mehilli,et al.  Comparison of balloon-expandable vs self-expandable valves in patients undergoing transcatheter aortic valve replacement: the CHOICE randomized clinical trial. , 2014, JAMA.

[5]  L. Räber,et al.  Short-term clinical outcomes among patients undergoing transcatheter aortic valve implantation in Switzerland: the Swiss TAVI registry. , 2014, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[6]  R. Lange,et al.  The German Aortic Valve Registry (GARY): in-hospital outcome , 2013, European heart journal.

[7]  M. Hochadel,et al.  Incidence and Clinical Impact of Stroke Complicating Percutaneous Coronary Intervention: Results of the Euro Heart Survey Percutaneous Coronary Interventions Registry , 2013, Circulation. Cardiovascular interventions.

[8]  R. Schiele,et al.  Predictors of one-year mortality after transcatheter aortic valve implantation for severe symptomatic aortic stenosis. , 2013, The American journal of cardiology.

[9]  O. Alfieri,et al.  [Guidelines on the management of valvular heart disease (version 2012). The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)]. , 2013, Giornale italiano di cardiologia.

[10]  P. Wenaweser,et al.  Transcatheter aortic valve implantation and cerebrovascular accidents. , 2012, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[11]  P. Serruys,et al.  Frequency and causes of stroke during or after transcatheter aortic valve implantation. , 2012, The American journal of cardiology.

[12]  P. Jüni,et al.  Cerebrovascular accidents complicating transcatheter aortic valve implantation: frequency, timing and impact on outcomes. , 2012, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[13]  J. Hendrikse,et al.  First-in-man experience with a new embolic deflection device in transcatheter aortic valve interventions. , 2012, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[14]  A. Schmermund,et al.  Risk of stroke after transcatheter aortic valve implantation (TAVI): a meta-analysis of 10,037 published patients. , 2012, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[15]  Alexander Ghanem,et al.  First-in-man use of a novel embolic protection device for patients undergoing transcatheter aortic valve implantation. , 2012, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[16]  P. Leprince,et al.  Registry of transcatheter aortic-valve implantation in high-risk patients. , 2012, The New England journal of medicine.

[17]  M. Mack,et al.  ACQUIRED CARDIOVASCULAR DISEASE Transcatheter ( TAVR ) versus surgical ( AVR ) aortic valve replacement : Occurrence , hazard , risk factors , and consequences of neurologic events in the PARTNER trial , 2012 .

[18]  P. Wenaweser,et al.  Transcranial Doppler-detected cerebral embolic load during transcatheter aortic valve implantation. , 2012, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[19]  E. Tay,et al.  A high-risk period for cerebrovascular events exists after transcatheter aortic valve implantation. , 2011, JACC. Cardiovascular interventions.

[20]  A. D. Cunningham,et al.  Long-term outcomes after transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis: the U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry. , 2011, Journal of the American College of Cardiology.

[21]  Stuart J Pocock,et al.  Transcatheter versus surgical aortic-valve replacement in high-risk patients. , 2011, The New England journal of medicine.

[22]  P. Pibarot,et al.  Cerebral embolism following transcatheter aortic valve implantation: comparison of transfemoral and transapical approaches. , 2011, Journal of the American College of Cardiology.

[23]  P. Serruys,et al.  Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium , 2010, European heart journal.

[24]  H. Eggebrecht,et al.  Transcatheter aortic valve implantation: first results from a multi-centre real-world registry. , 2011, European heart journal.

[25]  Alain Prat,et al.  Transcatheter aortic valve implantation: early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry. , 2011, European heart journal.

[26]  S. Pocock,et al.  Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. , 2010, The New England journal of medicine.

[27]  Hans H Schild,et al.  Risk and fate of cerebral embolism after transfemoral aortic valve implantation: a prospective pilot study with diffusion-weighted magnetic resonance imaging. , 2010, Journal of the American College of Cardiology.

[28]  P. Wenaweser,et al.  Transcatheter aortic valve implantation: predictors of procedural success--the Siegburg-Bern experience. , 2010, European heart journal.

[29]  M. Forsting,et al.  Silent and Apparent Cerebral Ischemia After Percutaneous Transfemoral Aortic Valve Implantation: A Diffusion-Weighted Magnetic Resonance Imaging Study , 2010, Circulation.

[30]  Alec Vahanian,et al.  Results of transfemoral or transapical aortic valve implantation following a uniform assessment in high-risk patients with aortic stenosis. , 2009, Journal of the American College of Cardiology.

[31]  Fabian Nietlispach,et al.  Transcatheter Aortic Valve Implantation: Impact on Clinical and Valve-Related Outcomes , 2009, Circulation.

[32]  P. Serruys,et al.  Procedural and 30-day outcomes following transcatheter aortic valve implantation using the third generation (18 Fr) corevalve revalving system: results from the multicentre, expanded evaluation registry 1-year following CE mark approval. , 2008, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[33]  Thomas Walther,et al.  Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: device success and 30-day clinical outcome. , 2007, Journal of the American College of Cardiology.

[34]  Philippe Ravaud,et al.  Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? , 2005, European heart journal.

[35]  K. Harjai,et al.  Characteristics of cerebrovascular accidents after percutaneous coronary interventions. , 2004, Journal of the American College of Cardiology.

[36]  Rolf Fimmers,et al.  Silent and apparent cerebral embolism after retrograde catheterisation of the aortic valve in valvular stenosis: a prospective, randomised study , 2003, The Lancet.

[37]  Assaf Bash,et al.  Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis: First Human Case Description , 2002, Circulation.

[38]  N. Weissman,et al.  Stroke Complicating Percutaneous Coronary Interventions: Incidence, Predictors, and Prognostic Implications , 2002, Circulation.

[39]  C. Grines,et al.  Scraping of aortic debris by coronary guiding catheters: a prospective evaluation of 1,000 cases. , 1998, Journal of the American College of Cardiology.

[40]  W. Aronow,et al.  Prognosis of congestive heart failure in patients aged > or = 62 years with unoperated severe valvular aortic stenosis. , 1993, The American journal of cardiology.