title: Novel approaches for prevention of stroke related to transcatheter aortic valve implantation.
abstract: Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutical option in patients with aortic stenosis. The methodology has evolved rapidly throughout the last decade. Nowadays, peri-procedural circulatory support, surgical vascular access, general anesthesia and mechanical ventilation are mainly reserved for selected patients. However, numerous challenges need to be addressed in order to further improved outcome of this distinct cohort: patient selection in general, vascular access strategies, long-term valve performance and paravalvular leakage. Another key issue is the risk of cerebrovascular events related to TAVI. In this article, the authors review the current literature on the risk of cerebrovascular events, the underlying mechanisms, the diagnostic read-outs of cerebral injury and their prognostic value, and ultimately discuss conceivable concepts for prevention of stroke associated with TAVI.
authors.affiliation: Department of Medicine/Cardiology, University of Bonn, Bonn, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ghanem
authors.forename: Justine
authors.initials: J
authors.lastname: Kocurek
authors.forename: Jan-Malte
authors.initials: JM
authors.lastname: Sinning
authors.forename: Marcel
authors.initials: M
authors.lastname: Weber
authors.forename: Christoph
authors.initials: C
authors.lastname: Hammerstingl
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.forename: Mariuca
authors.initials: M
authors.lastname: Vasa-Nicotera
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grube
authors.forename: Nikos
authors.initials: N
authors.lastname: Werner
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D018579:Patient Selection; D011379:Prognosis; D012121:Respiration, Artificial / Q000379:methods; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*