TAVR: LAA Thrombus Embolization as a Cause of Stroke?
Researchers suggest routine thrombus screening on cardiac CT
Left atrial appendage (LAA) thrombi were common in patients with atrial fibrillation (AF), operators found, and possibly linked to periprocedural stroke during transcatheter aortic valve replacement (TAVR).
As reported in JACC: Cardiovascular Interventions, an LAA thrombus was discovered on cardiac CT in 11% of patients undergoing evaluation for TAVR: 32% of the subgroup with AF and 1.6% of their peers without AF (OR 19.8, 95% CI 4.5-88),
For those who decided to proceed to TAVR, in-hospital strokes were especially common if the patient had an LAA thrombus (20% versus 3.8% for absence of thrombus). The overall in-hospital stroke frequency was 4.8%.