Cerebral Protection Devices in Transcatheter Aortic-Valve Replacement

Abstract

Transcatheter aortic valve replacement (TAVR) is a common procedure used in the treatment of severe aortic stenosis and other cardiac valve diseases. Although this procedure has been shown to be effective and safe in improving cardiac function and life expectancy in this population, there is an inherent risk of neurological complications such as stroke and cognitive impairment. In the last years, there has been a breakthrough in the development of brain protection devices that minimize the risk of brain embolism during the procedure. These devices are designed to capture clots and calcium debris that could become dislodged during the valve implant, therefore keeping the embolus from entering the nervous system via the supra-aortic vessels. Some studies indicate that using brain protection devices during an aortic valve replacement could substantially decrease the burden of stroke and other associated neurological complications. However, despite the promising expected results, further studies are required to sustain the benefit of using these devices, besides with the ongoing development in this area it would be fundamental a face-to-face interaction between the devices in the current development. Furthermore, although the experience with these devices is limited and the recent experience indicates they are safe, it would be fundamental to identify and take in consideration possible risks and complications related to these devices.