{"id":2402,"date":"2022-07-25T16:19:19","date_gmt":"2022-07-25T16:19:19","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=2402"},"modified":"2025-06-03T21:36:51","modified_gmt":"2025-06-03T21:36:51","slug":"tavr-stroke-risk-prevention-dr-isaac-george","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/tavr-stroke-risk-prevention-dr-isaac-george\/","title":{"rendered":"Stroke Risk &#038; TAVR: What Should Patients Know About Cerebral Protection Systems?"},"content":{"rendered":"<p>While transcatheter aortic valve replacement (TAVR) is considered one of the most transformational advances in heart valve therapy of the past 20 years, there remains an ongoing patient concern about stroke risk during this non-invasive procedure.<\/p>\n<p>For example, I just received a great question from Deb who asks, &#8220;I&#8217;m looking into TAVR and recently learned about an FDA-approved system to use when placing a TAVR to prevent plaque from breaking off, traveling to the brain, and causing a stroke. It is called <a href=\"https:\/\/www.bostonscientific.com\/en-US\/products\/embolic-protection\/sentinel-cerebral-protection-system.html\">SENTINEL Cerebral Protection System<\/a>. Are any physicians you know using the SENTINEL while implanting a TAVR aortic valve?&#8221;<\/p>\n<p>To learn more, we met with <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Isaac-George-New+York+City-New%20York.php\">Dr. Isaac George<\/a>, the Surgical Director of Structural Heart Disease at <a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/columbia-heart-valve-center\">NewYork-Presbyterian Hotel<\/a> in New York City. During his career, Dr. George has performed over 6,000 TAVRs and successfully treated many patients in our community including Patrick Purcell and Rita Guaraccina.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/RzqNC26XzGQ\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About TAVR &amp; Stroke Risk<\/h2>\n<p>Here are important insights about TAVR, stroke risk and the SENTINEL Cerebral Protection System from Dr. George:<\/p>\n<ul>\n<li>Using a shared decision making approach that considers the lifetime management of heart valve disease, Dr. George uses a variety of treatment options including TAVR and surgical aortic valve replacement (SAVR)\u00a0depending on their disease, their risk factors and their lifestyles.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Isaac-George-New+York+City-New%20York.php\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/profileImages\/353_129_164.jpg\" alt=\"Dr. Isaac George, Heart Surgeon\" width=\"129\" height=\"164\" \/><\/a><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Isaac-George-New+York+City-New%20York.php\">Dr. Isaac George (TAVR Expert)<\/a><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>According to Dr. George, the stroke risk for patients undergoing TAVR is 1.5% to 2.5%. &#8220;Stroke is a persistent issue in TAVR,&#8221; states Dr. George. &#8220;Calcium can break off at multiple time points during the procedure. Regardless of what we&#8217;ve done, better devices, more experience, stroke is a fixed commodity in terms of this procedure. That&#8217;s why it&#8217;s such a big deal.&#8221;<\/li>\n<li>The SENTINEL Cerebral Protection System is designed to minimize stroke risk during TAVR.\u00a0 The SENTINEL uses filters (or basked) that are temporarily implanted in the patient&#8217;s body to collect calcium debris during TAVR. This is a filter that&#8217;s inserted in the right radial artery at the time of TAVR and removed at the end of the procedure,&#8221; states Dr. George. &#8220;In theory, it has two baskets that collect any debris that&#8217;s liberated during the time of TAVR.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2414 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/SENTINEL-Cerebral-Protection-System-Device.jpg\" alt=\"SENTINEL-Cerebral-Protection-System-TAVR\" width=\"700\" height=\"389\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>The theoretical benefits of the SENTINEL include: (i) lower stroke rate, (ii) decrease risk of future stroke and (iii) decrease risk of cognitive decline.<\/li>\n<li>According to Dr. George, about 20% of cardiac centers use the SENTINEL Cerebral Protection System.\u00a0 The reasons for why cardiac centers do not use the SENTINEL include cost and conclusive evidence that the SENTINEL reduces stroke during TAVR, according to Dr. George.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2413 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/TAVR-SENTINEL-Stroke-Prevention-Benefits.jpg\" alt=\"SENTINEL-DEVICE-TAVR-BENEFITS\" width=\"700\" height=\"392\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>In September, 2022&#8230; At the upcoming Transcatheter Cardiovascular Therapeutics (TCT) conference being held in Boston, the results of the <a href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04149535\">PROTECT TAVR clinical trial<\/a> are expected to be released. The PROTECT TAVR clinical trial was designed to demonstrate that SENTINEL significantly reduces the risk of peri-procedural stroke (\u226472 hours) after TAVR. Dr. George states, &#8220;The next set of data that&#8217;s going to be coming out at TCT 2022 will be the PROTECT TAVR trial, which aims to definitively show that cerebral protection filters reduce stroke. We are very anxiously awaiting that study result.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Many Thanks to Dr. George, Columbia University Medical Center and NewYork-Presbyterian Hospital!<\/h2>\n<p>On behalf of our patient community, many thanks to <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Isaac-George-New+York+City-New%20York.php\">Dr. Isaac George<\/a> for sharing his clinical experiences and research specific to TAVR and stroke risk. We also want to thank the entire Columbia University Medical Center and <a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/columbia-heart-valve-center\">NewYork-Presbyterian Hospital<\/a> teams for taking such great care of patients with heart valve disease.<\/p>\n<p>Related Link:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/calcification-stroke-risk-gerdisch\/\">Surgeon Q&amp;A: Stroke Risk and Heart Valve Calcification<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard of hearing members of our community, I have provided a written transcript of my interview with Dr. George below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[11],"class_list":["post-2402","page","type-page","status-publish","hentry","category-medical-technology"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2402","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=2402"}],"version-history":[{"count":27,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2402\/revisions"}],"predecessor-version":[{"id":5873,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2402\/revisions\/5873"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=2402"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=2402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}