Neurologic complications after transcatheter aortic valve replacement are devastating. The etiologies of stroke in this setting are best addressed in an integrated fashion during each phase of the perioperative pathway. The conduct of this triphasic approach will continue to be refined to reduce the stroke risks even further, given the major focus on aspects such as embolic protection devices and valve thrombosis. This neurologic focus in transcatheter aortic valve replacement has transformed the investigational approach to neurologic events in cardiovascular clinical trials, resulting in novel guidelines for the diagnosis and assessment of neurologic injury after cardiovascular interventions.
Keywords: American College of Cardiology; American Heart Association; American Stroke Association; Embrella device; Montage device; Neurologic Academic Research Consortium; Sentinel device; Society of Thoracic Surgeons; Triguard device; Valve Academic Research Consortium; aortic arch; balloon-inflatable valve; bivalirudin; cerebral embolism; cognitive function; definitions; diffusion weighted magnetic resonance imaging; embolic protection; hemorrhage; heparin; infarction; modified Rankin scale; mortality; novel oral anticoagulants; platelet blockade; self-expanding valve; stroke; thrombosis; transcatheter aortic valve replacement; transcranial Doppler; transient ischemic attack; trial endpoints.
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