Stroke With Valve Tissue Embolization During Transcatheter Aortic Valve Replacement Treated With Endovascular Intervention

A case of right middle cerebral artery ‘tendonectomy’ following mitral valve replacement surgery

“…The embolus was removed using a Penumbra ACE reperfusion catheter. 9 Calcified material, valve tissue, pure collagenous material from the aortic wall, and thrombotic material have all been dislodged and become free emboli during TAVR cases. 10 TAVR is more susceptible to dislodging emboli and causing cerebral ischemia due to the physical contact between the catheter and the likely diseased aortic arch and valve, as well as the direct flow of blood from the ascending aorta to the brain.…”

Successful Stent-Retriever Thrombectomy for Acute Cerebral Embolization After Transcatheter Aortic Valve Implantation

“…1 In the other case, it detached from the native aortic valve. 2 To our knowledge, this is the first report on successful stent-retriever thrombectomy for acute stroke caused specifically by aortic plaque embolization after TAVI. Cooperation with the stroke care team and early invasive approach for unexpected embolization enable minimization of damage, as does the use of a filter device during the procedure to prevent further embolization.…”

High-risk Trans-Catheter Aortic Valve Replacement in a Failed Freestyle Valve with Low Coronary Height: A Case Report

“…Our literature search in PubMed for TAVR in the setting of mobile aortic valve mass yielded only one case report in which a 78-year-old man underwent TAVR with the CoreValve system in the presence of a 1 × 0.4-cm mobile aortic valve mass. He suffered immediate peri-procedural stroke and the embolized valve tissue was extracted with endovascular technique [8]. Although none of the embolic protection devices are currently FDA-approved, and we did not have experience in using these devices, their usage should be considered in experienced centers in the presence of mobile aortic valve mass, and we found a case report in which the Claret CE Pro™ (Claret Medical, Inc. Santa Rosa, CA, USA) embolic protection device was utilized in Europe in a patient with a mobile mass at the tip of the aortic valve leaflet and TAVR was performed without peri-procedural stroke [9].…”