Abstract 14669: Neurological Injury in Intermediate Risk Transcatheter Aortic Valve Implantation

Background: The application of TAVI to intermediate-risk cohorts is a controversial issue. In particular, significant concern surrounds the poorly defined incidence of neurological injury. While the attendant incidence is acceptable in high-risk and inoperable patients, it may not be so in lower-risk patients. Methods: Forty patients undergoing TAVI with the Edwards SAPIEN-XT™ prosthesis were prospectively studied. Participants underwent rigorous risk factor assessment including carotid ultrasonography, and computed tomography of the chest. Subclinical neurological injury was assessed using DWI sequences, pre-procedure and at 3±1 days post-procedure. Clinically apparent injury was assessed using the NIHSS, MoCA, and CAM tools out to 6 months post procedure. Results: The mean±SD participant age was 82±7 years, with a STS score of 5.1±2.5% and a EuroSCORE II of 4.8±2.4%. There was one (2.5%) minor stroke, one (2.5%) episode of postoperative delirium, and two patients (5%) suffered significant postoperative ...