Comments on: Risk and Fate of Cerebral Embolism After Transfemoral Aortic Valve Implantation A Prospective Pilot Study With Diffusion-Weighted Magnetic Resonance Imaging

By: Jacobo Kirsch, MD

Jacobo Kirsch, MD — Wed, 14 Apr 2010 20:59:34 +0000

Transapical approach has been shown to have an extremely low stroke risk. Does bypassing catheter transit through the aorta turn out to be the main difference?

In this recent post, the authors compared 100 patients undergoing TA-AVI versus conventional AVR. None of their patient’s s/p TA-AVI had a stroke versus 2 after conventional repair.

Transapical Aortic Valve Implantation in 100 Consecutive Patients: Comparison to Propensity-Matched Conventional Aortic Valve Replacement. (link)

By: Rubinshtein

Rubinshtein — Sun, 04 Apr 2010 15:16:58 +0000

I agree with Dr. Schoenhagen! Some of the answers will be available from the PARTNER Trial.

By: Paul Schoenhagen, MD

Paul Schoenhagen, MD — Thu, 01 Apr 2010 11:10:25 +0000

Interesting study! These are typically patients with advanced atherosclerotic disease burden, and known high mortality if untreated (see reference below). It would be critical to have a control group of matched patients with continued medical treatment.

Characterization and outcome of patients with severe symptomatic aortic stenosis referred for percutaneous aortic valve replacement.
Kapadia SR, Goel SS, Svensson L, et al.
J Thorac Cardiovasc Surg. 2009 Jun;137(6):1430-5.
PMID: 19464460