Courtesy of SBHCI.
The occurrence of a periprocedural neurological events is associated to an increased risk of death and morbidity at long term, both for transcatheter aortic valve replacement (TAVR) and for surgery.
The SURTAVI study, recently presented at the ACC meeting and simultaneously published by NEJM, showed that TAVR with self-expandable CoreValve or Evolut R, is not inferior to surgery as regards all- cause mortality or disabling stroke in patients at moderate risk, at 2 year follow up.
All patients suspected of a neurological events were assessed with mini mental test and NIH scale.
At 30 days, a lower rate of neurological events was observed with TAVR vs. surgery (3.3% vs. 5.4%; p=0.031). This difference in favor of TAVR was maintained at 2 year follow up, though it was not as significant (6.3% vs. 8.0%, p=0,143).
Most of neurological events occurred within the first days after procedure. This was especially true for TAVR, where most occurred within 24 hrs, (while surgery continued to show events until day 4).
Conclusion
The incidence of early neurological events was lower in patients undergoing TAVR compared to patients undergoing surgery. Those presenting neurological events, (apart from the treatment group) required longer times of intensive care, hospitalization and were more often referred to rehabilitation centers.
Courtesy of SBHCI.
Original Title: Neurological complications after transcatheter aortic valve implantation with a self- expanding bioprosthesis or surgical aortic valve replacement in patients at intermediate-risk for surgery.
Presenter: A. Pieter Kappetein.
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