Aortic sinotubular atherosclerotic debris associated with cerebral embolic events can be identified by transthoracic echocardiography

Increased Intima-Media Thickness of the Ascending Aorta May Predict Neurological Complications Associated with TAVI

OBJECTIVES

Neurological complications associated with transcatheter aortic valve implantation (TAVI) are important due to its morbidity and mortality risks. The purpose of this study was to investigate the importance of the features of the aortic valve and ascending aorta to predict the neurological complications associated with TAVI.

METHODS

The patients for whom the heart team decided to perform TAVI were included in the study. In order to assess possible neurological complications, cerebral diffusionweighted magnetic resonance imaging(MRI) was performed pre- and post-operatively. The diameter of the patients' aortic root and ascending aorta, aortic valve scores, intima media thickness of the ascending aorta were measured from their transesophageal echocardiography records.

RESULTS

A total of 108 patients constituted the study population. 31 patients were found to develop a new lesion (MR+) detected on MRI after TAVI, while 76 patients did not have any new lesions (MR-). The groups did not have any significant differences in their aortic valve features and scores. However, AA-IMT was found to be higher in the MR+ group (1.8mm [1.6-2.3] vs 1.4mm [1.2-1.8] interquartile range). The multivariate logistic regression analysis conducted to detect new lesions revealed that AA-IMT led to a significantly increased risk.

CONCLUSION

The features of the ascending are more important than the demographic characteristics of patients and features of the native valve in predicting new lesions on MRI scans and thus neurological events after TAVI.