The Role of Cerebral Embolic Protection in Transcatheter Aortic Valve Replacement

Stroke is one of the most feared complications of transcatheter aortic valve replacement (TAVR) and is associated with an increased risk of morbidity and mortality [1-4]. Its consequences can be disastrous with permanent significant disability in 40% of the survivors, social isolation and financial problems in up to 80% of the patients and a 6-fold increase in mortality rate during the first month following TAVR [5-8]. It is caused by periprocedural embolization occurring during balloon dilatation, manipulation of the delivery system in the aortic arch, valve positioning and valve deployment [9]. Histopathologic findings have revealed that emboli can consist of native valve tissue, arterial wall tissue, calcification, thrombus and foreign material [10].