Cerebral protection during transcatheter aortic valve implantation in an extreme high-risk patient

Abstract

Stroke during transcatheter aortic valve replacement is one of the most feared complications. New technologies have been developed, attempting to prevent cerebral embolization of thrombotic and calcific debris. We report a 78-year-old patient (EuroSCORE log 45.6%, STS Stroke Score 5.1%) with calcific aortic stenosis at particular risk for cerebrovascular accidents. The patient underwent transapical transcatheter aortic valve replacement using the dual filter-based Claret SentinelTM Device for cerebral protection. Claret Sentinel Device use was associated with capture of macroscopic debris. Postoperatively, no neurological deficits could be detected by the National Institutes of Health Stroke Scale and modified Rankin scale.