Background: Transcatheter aortic valve replacement (TAVR) has become
the dominant treatment for aortic valve disease. While TAVR safety has improved
over time, concern remains over the occurrence of cerebrovascular accidents (CVA)
secondary to device placement, which is associated with increased morbidity and
mortality. The Sentinel Cerebral Protection System (CPS) was developed to reduce
the risk of embolic strokes associated with debris produced during TAVR. Studies
evaluating Sentinel CPS efficacy have produced conflicting results, and there is
little understanding of which patients are selected for device placement in
“real-world” settings. With no existing guidelines on device use, the purpose
of this study was to describe and compare the characteristics of patients who
receive CPS with those who do not in a “real-world” setting of consecutive TAVR
patients and evaluate its impact on postoperative complications, namely stroke.
Methods: This was a single-center, retrospective study of all patients
undergoing TAVR between July 1, 2019, and December 31, 2020. Patient
demographics, baseline, and perioperative characteristics were collected
prospectively using the Society of Thoracic Surgeons (STS)/American College of
Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry and our institution’s
TAVR database for analysis. Postoperative outcomes were assessed using primary
endpoints of in-hospital/30-day stroke and the composite of death, stroke, and
bleeding/vascular events at one-year. To adjust for baseline differences, a
propensity score was developed including all factors that were different between
groups, and Multivariate Cox Regression analysis was used to control for these
differences. Patient follow-up was 97% complete at 12 months with 100%
echocardiographic follow-up. Results: A total of 242 consecutive
patients (57.9% male) were analyzed, with a mean age of 79.9
Announcements
Open Access
Original Research
Patient Characteristics and Outcomes Associated with Sentinel Protection Device Use in Patients with Aortic Valve Disease Undergoing TAVR in a “Real-World” Setting
Habib Jabagi1,2, Richard E. Shaw1, Lara Gharibeh3, Rajiv Tayal4, Hussein Rahim4, Francis Kim4, Alex Zapolanski1, Juan B. Grau1,5,*
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1
Division of Cardiothoracic Surgery, The Valley Hospital, Ridgewood, NJ 07450, USA
2
Department of Cardiovascular Surgery, Mt. Sinai Hospital, Icahn School of Medicine at Mt. Sinai, New York, NY 10001, USA
3
Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON K1Y 4W7, Canada
4
Division of Interventional Cardiology, The Valley Hospital, Ridgewood, NJ 07450, USA
5
Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
Rev. Cardiovasc. Med. 2024, 25(1), 3;
https://doi.org/10.31083/j.rcm2501003
Submitted: 6 July 2023 | Revised: 5 September 2023 | Accepted: 18 September 2023 | Published: 4 January 2024
(This article belongs to the Section Cardiovascular Quality and Outcomes)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract
Keywords
sentinel cerebral protection system (CPS)
transcatheter aortic valve replacement (TAVR)
aortic valve disease
cerebrovascular accidents (CVA)
stroke