The Impact Of Over-Sizing Transcathter Heart Valve Deployment For Silent Cerebral Infarction After Transfemoral Aortic Valve Replacement

Introduction: The incidence of symptomatic cerebral infarction after transcatheter aortic valve replacement (TAVR) ranges from 2.0% to 5.0%. Furthermore, the incidence of silent cerebral infarction (SCI) detected by diffusion-weighted magnetic resonance imaging (DW-MRI) exceeds 50%, and it has been reported that SCI might relate long-term cognitive impairment. However, there has not been one point of view as predictors for SCI after TAVR. Therefore, the present study aimed to investigate the predictor of SCI after transfemoral (TF)-TAVR. Methods: We enrolled 58 consecutive patients (median age: 84 y.o (quartile 80-86), and 34.5% male)), who underwent TF-TAVR and performed DW-MRI within 10 days after procedure, between January 2016 and March 2017. We examined the incidence of SCI, and counted high-intensity spot (HIS) at DW-MRI in all patients. Subsequently, we evaluated the predictor of SCI using logistic regression analysis. As confounders, we selected Society of Thoracic Surgeon score (STS), calcium vol...