| Risk and fate of cerebral embolism after transfemoral aortic valve implantation: a prospective pilot study with diffusion-weighted magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 20188503 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was prospective investigation of silent and clinically apparent cerebral embolic events and neurological impairment after transfemoral aortic valve implantation (TAVI). BACKGROUND: TAVI is a novel therapeutic approach for multimorbid patients with severe aortic stenosis. We investigated peri-interventional cerebral embolism with diffusion-weighted magnetic resonance imaging (DW-MRI) and its relationship to clinical and serologic parameters of brain injury. METHODS: Cerebral DW-MRI was performed before, directly, and 3 months after TAVI with the current third-generation self-expanding CoreValve (Medtronic, Minneapolis, Minnesota) prosthesis. At the timepoints of the serial MRI studies, focal neurological impairment was assessed according to the National Institutes of Health Stroke Scale (NIHSS), and serum concentration of neuron-specific enolase (NSE), a marker of the volume of brain tissue involved in an ischemic event, were determined. RESULTS: Thirty patients were enrolled; 22 completed the imaging protocol. Three patients (10%) had new neurological findings after TAVI, of whom only 1 (3.6%) had a permanent neurological impairment. Of the 22 TAVI patients with complete imaging data, 16 (72.7%) had 75 new cerebral lesions after TAVI presumed to be embolic. The NIHSS and NSE were not correlated with DW-MRI lesions. CONCLUSIONS: The incidence of clinically silent peri-interventional cerebral embolic lesions after TAVI is high. However, in this cohort of 30 patients, the incidence of persistent neurological impairment was low. (Incidence and Severity of Silent and Apparent Cerebral Embolism After Conventional and Minimal-invasive Transfemoral Aortic Valve Replacement; NCT00883285). |
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Authors:
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Alexander Ghanem; Andreas M?ller; Claas P N?hle; Justine Kocurek; Nikos Werner; Christoph Hammerstingl; Hans H Schild; J?rg O Schwab; Fritz Mellert; Rolf Fimmers; Georg Nickenig; Daniel Thomas |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2010-02-24 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 55 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-02 Completed Date: 2010-06-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1427-32 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine/Cardiology, University of Bonn, Bonn, Germany. ghanem@uni-bonn.de |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00883285 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aortic Valve / surgery* Aortic Valve Stenosis / surgery* Diffusion Magnetic Resonance Imaging Female Femoral Artery / surgery Heart Valve Prosthesis Implantation / adverse effects* Humans Intracranial Embolism / diagnosis*, etiology* Male Pilot Projects Risk Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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