Transcarotid transcatheter aortic valve replacement with cerebral embolic protection

Daniel McGrath; Payam Salehi; Andrew Weintraub; Yong Zhan

doi:10.1111/jocs.16417

Transcarotid transcatheter aortic valve replacement with cerebral embolic protection

J Card Surg. 2022 Jun;37(6):1779-1782. doi: 10.1111/jocs.16417. Epub 2022 Mar 17.

Authors

Daniel McGrath¹, Payam Salehi¹, Andrew Weintraub¹, Yong Zhan¹

Affiliation

¹ Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.

PMID: 35301761
DOI: 10.1111/jocs.16417

Abstract

There remains concern about the risk of stroke with transcarotid transcatheter aortic valve replacement (TAVR). We describe the use of the Sentinel cerebral protection device with transcarotid TAVR in a patient at high risk for embolic complications. Deployment of the Sentinel filter in the innominate artery accommodated the insertion of the TAVR device through the bovine aortic arch via the contralateral carotid artery. By adapting the "flip-n-flex" technique from our previous transaxillary TAVR experience, we performed left transcarotid TAVR with the Sentinel device in an ergonomic manner and achieved coaxial placement of the transcatheter valve. Inspection of the Sentinel filter after the case revealed captured embolic debris.

Keywords: cerebral protection; stroke; transcarotid; transcatheter aortic valve replacement.

Publication types

Case Reports

MeSH terms

Aortic Valve / surgery
Aortic Valve Stenosis* / complications
Aortic Valve Stenosis* / surgery
Embolic Protection Devices*
Humans
Intracranial Embolism* / etiology
Intracranial Embolism* / prevention & control
Prosthesis Design
Risk Factors
Transcatheter Aortic Valve Replacement* / adverse effects
Treatment Outcome