Abstract

CEREBRAL EMBOLIC PROTECTION DURING TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR): CLINICAL EVENT META-ANALYSIS

Ziad Eidhah Sharaf Alzahrani*, Abdullah Ali Saeed Alzahrani, Abdulaziz Ibrahim Abbas Alghamdi, Abdulmohsin Ahmed Ali Alghamdi, Abdulraheem Ahmad Abdulraheem Alghamdi, Abdulrahman Mohammed Hassan Alzahrani, Majed Abdullah Mohammed Almuafa, Alabbas Saleh Abbas Alghamdi, Razan Mahmoud A. Alshaheen, Abdulhamid Mahmoud A. Alshaheen

Abstract

Background & Purpose: Cerebral protection devices gain cerebral protection either through a filtering system (a landing net extracting emboli from the circulation), or a deflection system (alternating the route of the emboli away from the cerebral circulation to the systemic circulation). The Aim of this work is to provide cumulative data about the effect of Cerebral Embolic Protection (EP) During Transcatheter Aortic Valve Replacement (TAVR) on cardiac patients. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Cardiology RCTs, clinical trials, and comparative studies, which studied the outcome of EP group versus Control group of TAVR patients. A meta-analysis was done using fixed and randomeffect methods. The primary outcome was death or stroke event. The secondary outcome was rate of new ischemic lesions. Results: A total of 6 studies were identified involving 1185 patients, with 656 patients in EP group, and 529 patients in Control group. Regarding primary outcome measures, the fixed-effects model of the meta-analysis study showed highly significant decrease in death or stroke events in EP group compared to Control group (p = 0.003). Regarding secondary outcome measures, the fixed-effects model of the meta-analysis study showed non-significant difference in new ischemic lesions in EP group compared to Control group (p > 0.05). Conclusion: To conclude, use of EP seems to be related to reductions in mortality rate and related to early clinical neurological effectiveness in patients undergoing TAVR.

Keywords: Cerebral Embolic Protection, TAVR.