Throughout Dr. Samir Kapadia’s career, he’s performed over 1,000 Transcatheter Aortic Valve Replacements. The director of the Catheterization Laboratory at the Cleveland Clinic in Cleveland, Ohio, weighs in on the procedure and encourages patients to consider cerebral embolic protection.
Samir Kapadia, M.D.
Director, Catheterization Laboratory, Cleveland Clinic
What is my risk of stroke during a Transcatheter Aortic Valve Replacement (TAVR) procedure, and how could cerebral embolic protection potentially reduce that risk?
The risk of stroke from TAVR is an ongoing, significant concern. The evidence shows it is as high as 3.5 percent, and clinically silent brain infarctions, as seen on MRI, occur in as many as 80 percent of patients and are associated with neurocognitive function changes. The FDA-cleared Sentinel device was designed to address the concern of peri-procedural stroke after TAVR, specifically those strokes related to embolic debris that is dislodged during valve replacement. Robust clinical evidence demonstrates that peri-procedural stroke rate was reduced by 63 percent when Sentinel was used during TAVR.
What is the patient’s reaction when you explain the benefit of cerebral embolic protection?
It’s a very positive reaction. More and more patients are asking for Sentinel during heart valve replacement procedures. We want to give them every protection we can. There’s an additional level of confidence that comes from knowing the efficacy and extra safety layer cerebral embolic protection provides during the TAVR procedure. Importantly, the device is extremely safe and easy to use. Sentinel protects the patients’ brains from potential harmful debris that can come loose during TAVR and block the flow of blood to the brain.
Would you recommend cerebral embolic protection to a family member?
Absolutely. Patients can benefit from having cerebral protection when undergoing TAVR procedures, since clinical data shows that 99 percent of patients generate debris during the TAVR procedure.