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Review
. 2025 Mar 25;54(2):167-174.
doi: 10.3724/zdxbyxb-2024-0414.

[Advances in stroke after transcatheter aortic valve replacement]

[Article in Chinese]
Yue Zhou  1 , Renqiang Yang  2
Affiliations
Review

[Advances in stroke after transcatheter aortic valve replacement]

[Article in Chinese]
Yue Zhou et al. Zhejiang Da Xue Xue Bao Yi Xue Ban. .

Abstract
in English, Chinese

With the clinical generalization and popularization of transcatheter aortic valve replacement (TAVR), cerebrovascular events related to TAVR occur more frequently, which significantly impairs neurocognitive function, increases mortality, and seriously affects prognosis and quality of life in these patients. However, the reported incidence rates of TAVR-related stroke differ in literature due to inconsistent diagnostic criteria. According to the onset time, TAVR-related stroke can be divided into acute (≤24 h), subacute (24 h-30 d), early (31 d-1 year) and late (>1 year) types, and the cause of stroke generally varies according to the onset time. Both surgical (balloon aortic valvuloplasty, types of transcatheter heart valve, alternative access) and non-surgical (valvular calcium burden, bicuspid aortic valve, subclinical leaflet thrombosis, postoperative new-onset atrial fibrillation) can be related to the occurrence of TAVR-related stroke. Postprocedural monitoring, postprocedural antithrombotic therapy, and cerebral embolic protection devices are important for the prevention of TAVR-related stoke. This article reviews the research progress on TAVR-related stroke, focusing on its epidemiology, risk factors and preventive measures, aiming to provide reference for the clinical management of stroke in TAVR.

随着经导管主动脉瓣置换术（TAVR）的临床推广和普及，TAVR相关脑血管事件一直是临床关注的重点，这类不良事件明显降低神经认知功能、增加患者病死率，严重影响患者的预后及生活质量。目前，由于TAVR相关脑卒中诊断标准的不一致性导致其发生率存在明显差异。根据脑卒中发生的时间可分为急性（24 h及以内）、亚急性（24 h~30 d）、早期（31 d~1年）和晚期（超过1年），不同时期脑卒中的发生机制有所不同。影响TAVR相关脑卒中发生的相关因素包括手术因素（主动脉瓣球囊扩张成形术、经导管心脏瓣膜类型、手术入路）和非手术因素（瓣膜钙化负荷、主动脉瓣二瓣化畸形、亚临床瓣叶血栓形成、术后新发心房颤动）。TAVR后监测、抗栓治疗及脑栓塞保护装置的应用对预防脑卒中有重要的临床意义。本文综述了TAVR相关脑卒中的流行病学、危险因素和预防措施，以期为其临床管理提供科学依据。.

Keywords: Cerebrovascular events; Review; Stroke; Transcatheter aortic valve replacement.

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Conflict of interest statement

所有作者均声明不存在利益冲突

The authors declare that there is no conflict of interests

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