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Lourdes Offers New Filter Device to Help Protect Valve Replacement Patients From Stroke

Our Lady of Lourdes Medical Center is now offering patients who have undergone transcatheter aortic valve replacement (TAVR) the Sentinel® Cerebral Protection System, a first-of-its-kind filter to catch embolic debris and prevent a possible stroke.

The Sentinel® Cerebral Protection System, developed by Boston Scientific, received FDA approval in 2017 and became available last fall. The first Sentinel procedure at Lourdes was performed in late February on a 94-year-old man.

“There’s a subset of patients who are prone to stroke during TAVR” said Ibrahim Moussa, DO, FACC, FSCAI, RPVI, clinical director of the Lourdes Cardiac Catheterization Laboratory. “Whether we are deploying an expandable balloon or a self-expanding valve inside the native valve, there is a chance embolic debris—calcium, blood clots or plaque—can break off, travel to the brain and cause an ischemic stroke or other damage. The Sentinel device is designed to catch that debris.” 

At the beginning of the TAVR procedure, the Sentinel is inserted into the radial artery in the right arm. It is then threaded through the arm to the brain arteries, where a proximal embolic filter is placed in the brachiocephalic artery and a distal embolic filter in the left common carotid artery. Both arteries supply blood to the brain. The placement takes about five minutes.

The filters, which look like small baskets, collect any debris released during the procedure, some of which can be several millimeters in size. Afterward, the baskets collapse and are removed from the patient through the catheter.

“The filters do not interfere with the TAVR catheter, which is usually inserted through the femoral artery in the upper leg,” said Dr. Moussa.

Transcatheter aortic valve replacement (TAVR) is one of the effective treatments for severe aortic stenosis—a narrowing of the aortic valve that limits blood flow causing chest pain, shortness of breath, dizziness and fainting.

While TAVR greatly improves the quality and length of a patient’s life, there is a small chance that the procedure can lead to a stroke. To help reduce the risk of stroke, the cardiac team at Our Lady of Lourdes Medical Center is using a first-of-its-kind filter to catch embolic debris and prevent a possible stroke.

Clinical trials found the Sentinel device reduced the incidence of strokes by 63 percent within the first 72 hours of the procedure.

The cardiac team at Our Lady of Lourdes Medical Center performs about 150 TAVR procedures each year.

The TAVR procedure is primarily performed in patients who are at high risk for complications from traditional open-heart surgery due to age or other conditions. It was recently approved for patients who are considered intermediate-risk—often younger and in better overall health. Patients are walking around a few hours after the procedure and typically spend one to three days in the hospital before returning home.

According to Dr. Moussa, candidates to receive the Sentinel device during their procedure: 

  • Are older, with severe atherosclerotic disease
  • Previously suffered a stroke
  • Have end-stage renal disease

 “Even a single stroke is one stroke too many, especially if it’s yours or a loved one’s,” said Dr. Moussa. “We are pleased to offer this device for the safety of our patients.”

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