Stroke Associated With Surgical and Transcatheter Treatment of Aortic Stenosis: A Comprehensive Review

Perspective:

Stroke is a potential complication of treating patients with aortic stenosis via surgical aortic valve replacement (AVR), transcatheter aortic valve replacement (TAVR), and balloon aortic valvuloplasty. The risk of stroke after AVR in the general population is approximately 1.5%, and the risk is increased (to approximately 2-4%) in older and higher-risk patients. Strokes were reported in 1.5-6% of patients treated with TAVR, and in the only randomized trial of AVR versus TAVR, there was an increased risk of 30-day strokes (minor and major strokes and transient ischemic attacks) with TAVR (5.5% vs. 2.4%, p = 0.04). Further prospective studies with large numbers of patients undergoing TAVR and AVR with detailed neurology assessments, neurocognitive testing, and neuroimaging evaluations performed by trained neurologists will need to be done to better determine the neurologic risks of these procedures.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: Stroke, Balloon Valvuloplasty, Ischemic Attack, Transient, Neuroimaging, Cardiology, Neurology, Angioplasty


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