Large Tissue Debris Causing Cerebral Embolism After Transcatheter Aortic Valve Replacement

• Published in: International Heart Journal Vol. 65; no. 1; pp. 152 - 154
• Main Authors: Kagawa, Shunsuke, Matsumura, Yoshiki, Matsumoto, Ryo, Abe, Yukio, Terada, Aiko, Ishiguro, Tomoya, Naruko, Takahiko
• Format: Journal Article
• Language: English
• Published: Japan International Heart Journal Association 01.01.2024; Japan Science and Technology Agency
• Subjects: Aged, 80 and over; Aortic stenosis; Aortic valve; Aortic Valve - surgery; Aortic Valve Stenosis - complications; Brain Ischemia; Cerebral blood flow; Cerebral infarction; Cerebral Infarction - etiology; Congestive heart failure; Embolism; Female; Humans; Intracranial Embolism - diagnosis; Intracranial Embolism - etiology; Intracranial Embolism - surgery; Ischemia; Mechanical aspiration; Risk Factors; Stenosis; Stroke - complications; Thrombolysis; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - methods; Treatment Outcome; Aortic stenosis; Cerebral infarction; Mechanical aspiration
• ISSN: 1349-2365; 1349-3299
• DOI: 10.1536/ihj.23-337

Cerebral vascular embolism is one of the complications of transcatheter aortic valve replacement (TAVR). Thrombolytic therapy is not expected to be effective when embolic material consists of a large tissue fragment. Instead, mechanical aspiration may be more effective therapy for acute cerebral infarction after TAVR. Here, we describe the case of an 87-year-old woman with aortic valve stenosis and heart failure who underwent TAVR using a self-expandable valve. Acute cerebral infarction with left middle cerebral artery occlusion caused by a large tissue fragment developed after the procedure.