- Oral presentation
- Open Access
Difference between cerebral embolic events following Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR): a diffusion weighted MRI study
© Uddin et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Diffusion Weighted Imaging
- Transcatheter Aortic Valve Implantation
- Lesion Volume
- Severe Aortic Stenosis
- Surgical Aortic Valve Replacement
Transcatheter Aortic Valve Implantation (TAVI) is used to treat symptomatic severe aortic stenosis in a non-surgical high risk population. The incidence of stroke and micro-infarction is higher in the TAVI population compared to surgical aortic valve replacement (SAVR) at 30 days, which may be due to various factors such as valve calcification and aortic atheroma. However, the natural history and clinical consequences of micro-infarction is unknown.
Cerebral imaging was conducted before TAVI/SAVR, at <7 days post-procedure and 6 months post-procedure. MRI scans were performed on a 1.5T system (Intera, Philips or Avanto, Siemens) using a protocol of T2 weighted fast field echo, T2 turbo field echo and diffusion weighted imaging (DWI) (22 slices, 5 mm thick, 1mm gap, FOV 350, RFOV 100). Three neuroradiologists independently analysed the scans and were blinded to clinical details to avoid bias. New cerebral lesions were measured (<5 mm or>5 mm) and the vascular territory described. Quantification of cerebral infarct lesion volume was performed by manual planimetry using post processing software (Qmass 7.2 Medis, The Netherlands).
There is a significantly greater number of new micro-embolic events after TAVI compared to SAVR. However all of these lesions appear to completely resolve by 6 months.
SP is funded by a British Heart Foundation fellowship (FS/10/62/28409).
SP and JPG receive an educational research grant from Philips Healthcare.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.