‘Silent cerebral microbleeds common after TAVR’

The rate of new cerebral microbleeds (CMBs) associated with transcatheter aortic-valve replacement (TAVR) can be “quite high,” affecting 6-month neurological outcomes, according to investigators of new imaging research.

New microbleeds after TAVR
The observational study of 84 high-surgical-risk patients with aortic stenosis showed that 26% had one or more CMBs before undergoing TAVR, as measured by cerebral MRI. But 23% of the total participants had at least one new CMB 3 days after the procedure. In addition, having that kind of brain bleed was significantly associated with worse neurologic scores at baseline (P=0.01) and at the 6-month follow-up (P=0.008).

Von Willebrand disease
Significant predictors for a new CMB occurrence during TAVR included a prolonged fluoroscopy time and persistence of acquired von Willebrand disease.

Coinvestigator Dr Eric Van Belle (Heart Institute, Centre Hospitalier Régional Universitaire [CHRU], Lille, France) told attendees at the American College of Cardiology (ACC) 2017 Scientific Sessions that the long-term clinical impact of the findings “will need to be further clarified,” such as in MRI substudies. “We’ll also need dedicated studies to better understand the interaction between acquired von Willebrand disease and anticoagulation in this very peculiar population,” he added.

 

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Source: Medscape | April 17, 2017

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