Transcatheter aortic valve implantation: Does cerebral protection decrease cerebral ischemia

Problem: Aortic stenosis is a common problem for the elderly. When symptoms begin life expectancy declines rapidly. The definitive treatment for a diseased valve is surgical replacement. A new method of replacing the aortic valve is Transcatheter Aortic Valve Implantation (TAVI). There are multiple risks of this procedure and one of the most devastating is stroke. Is there research investigating methods to decrease the amount of emboli entering the brain during TAVI? Methods: A PUBMED online search utilizing the resources of Weill Cornell Medical College Library was conducted for articles that investigated TAVI procedures and cerebral ischemia and stroke. Only full text English language journals were selected for this literature review. Results: All studies analyzed for this review recognized stroke as a main complication related to TAVI. Several authors discussed the need for further research into protection for the cerebral circulation during TAVI. Conclusions: There are novel cerebral protection devices but no long term data into their efficacy. To make TAVI a safer option for aortic valve replacement research should be conducted to examine cerebral protection during TAVI.