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Cerebral infarction due to dispersal of aortic atheromas detected by transoesophageal echocardiography during transcatheter aortic valve implantation
  1. Masashi Koga,
  2. Masaki Izumo,
  3. Yasuhiro Tanabe and
  4. Yoshihiro John Akashi
  1. Division of Cardiology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
  1. Correspondence to Dr Masashi Koga; masashi.koga{at}


Transcatheter aortic valve implantation (TAVI) is a rapidly evolving treatment option with an inherent risk of causing cerebral infarctions. The mechanism of cerebral infarction during TAVI mainly involves embolisms from the aortic wall and valve. Transoesophageal echocardiography (TEE) is useful for detecting aortic atheromas. We present the case of a patient in whom the dispersal of aortic atheromas was monitored by TEE during TAVI. This report demonstrates the importance of preoperatively predicting embolisms from aortic atheromas in patients with severe aortic stenosis.

  • interventional cardiology
  • valvar diseases
  • stroke

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  • Contributors All the authors were involved in the clinical management of the patients. MK drafted and MI, YT and YJA revised the manuscript. YJA approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.