Document Detail


An embolic deflection device for aortic valve interventions.
MedLine Citation:
PMID:  21087748     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We describe initial human experience with a novel cerebral embolic protection device.
BACKGROUND: Cerebral emboli are the major cause of procedural stroke during percutaneous aortic valve interventions.
METHODS: With right radial artery access, the embolic protection device is advanced into the aortic arch. Once deployed a porous membrane shields the brachiocephalic trunk and the left carotid artery deflecting emboli away from the cerebral circulation. Embolic material is not contained or removed by the device. The device was used in 4 patients (mean age 90 years) with severe aortic stenosis undergoing aortic balloon valvuloplasty (n = 1) or transcatheter aortic valve implantation (n = 3).
RESULTS: Correct placement of the embolic protection device was achieved without difficulty in all patients. Continuous brachiocephalic and aortic pressure monitoring documented equal pressures without evidence of obstruction to cerebral perfusion. Additional procedural time due to the use of the device was 13 min (interquartile range: 12 to 16 min). There were no procedural complications. Pre-discharge cerebral magnetic resonance imaging found no new defects in any of 3 patients undergoing transcatheter aortic valve implantation and a new 5-mm acute cortical infarct in 1 asymptomatic patient after balloon valvuloplasty alone. No patient developed new neurological symptoms or clinical findings of stroke.
CONCLUSIONS: Embolic protection during transcatheter aortic valve intervention seems feasible and might have the potential to reduce the risk of cerebral embolism and stroke.
Authors:
Fabian Nietlispach; Namal Wijesinghe; Ronen Gurvitch; Edgar Tay; Jeffrey P Carpenter; Carol Burns; David A Wood; John G Webb
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-03-04     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1133-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Aortic Valve Stenosis / physiopathology,  therapy*
Blood Pressure
British Columbia
Cardiac Catheterization / adverse effects,  instrumentation*,  methods
Catheterization
Embolic Protection Devices*
Feasibility Studies
Female
Heart Valve Prosthesis Implantation / adverse effects,  instrumentation*,  methods
Humans
Intracranial Embolism / diagnosis,  etiology,  prevention & control*
Magnetic Resonance Imaging
Male
Prosthesis Design
Radial Artery
Radiography, Interventional
Stroke / etiology,  prevention & control
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2010 Nov;3(11):1139-40   [PMID:  21087749 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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