title: Filter neuroprotection of a single patent internal carotid artery during transapical aortic valve implantation.
abstract: The finding of a mobile calcific plaque attached to the aortic valve cusp during transcatheter aortic valve implantation (TAVI/TAVR) necessitated utilization of an embolic protection device, for cerebral protection. We report the urgent but successful deployment of such a filter in a patient with a single patent internal carotid artery. Although stroke rates observed in first-generation TAVI trials were higher than those reported following conventional open aortic valve replacement, adjunctive neuroprotective measures, particularly in patients with a large amount of threatened cerebral territory, may minimize potential neurologic injury.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarangi
authors.forename: John F
authors.initials: JF
authors.lastname: Bresnahan
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Bruce
authors.forename: Gössl
authors.initials: G
authors.lastname: Mario
authors.forename: Rakesh M
authors.initials: RM
authors.lastname: Suri
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D002343:Carotid Artery, Internal; D057505:Embolic Protection Devices; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D008297:Male; D000066829:Neuroprotection; D058226:Plaque, Atherosclerotic / Q000150:complications; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency