The Silent and apparent neurological injury in transcatheter aortic valve implantation study (SANITY): concept, design and rationale

Jonathon P. Fanning, Allan J. Wesley, David G. Platts, Darren L. Walters, Eamonn M. Eeles, Michael Seco, Oystein Tronstad, Wendy Strugnell, Adrian G. Barnett, Andrew J. Clarke, Judith Bellapart, Michael P. Vallely, Peter J. Tesar, John F. Fraser

    Research output: Contribution to journalArticlepeer-review

    19 Citations (Scopus)
    24 Downloads (Pure)

    Abstract

    Background: The incidence of clinically apparent stroke in transcatheter aortic valve implantation (TAVI) exceeds that of any other procedure performed by interventional cardiologists and, in the index admission, occurs more than twice as frequently with TAVI than with surgical aortic valve replacement (SAVR). However, this represents only a small component of the vast burden of neurological injury that occurs during TAVI, with recent evidence suggesting that many strokes are clinically silent or only subtly apparent. Additionally, insult may manifest as slight neurocognitive dysfunction rather than overt neurological deficits. Characterisation of the incidence and underlying aetiology of these neurological events may lead to identification of currently unrecognised neuroprotective strategies. Methods: The Silent and Apparent Neurological Injury in TAVI (SANITY) Study is a prospective, multicentre, observational study comparing the incidence of neurological injury after TAVI versus SAVR. It introduces an intensive, standardised, formal neurologic and neurocognitive disease assessment for all aortic valve recipients, regardless of intervention (SAVR, TAVI), valve-type (bioprosthetic, Edwards SAPIEN-XT) or access route (sternotomy, transfemoral, transapical or transaortic). Comprehensive monitoring of neurological insult will also be recorded to more fully define and compare the neurological burden of the procedures and identify targets for harm minimisation strategies. Discussion: The SANITY study undertakes the most rigorous assessment of neurological injury reported in the literature to date. It attempts to accurately characterise the insult and sustained injury associated with both TAVI and SAVR in an attempt to advance understanding of this complication and associations thus allowing for improved patient selection and procedural modification.
    Original languageEnglish
    Article number45
    Pages (from-to)1-10
    Number of pages10
    JournalBMC Cardiovascular Disorders
    Volume14
    DOIs
    Publication statusPublished - 5 Apr 2014

    Bibliographical note

    Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

    Keywords

    • Aortic valve stenosis
    • Cerebrovascular disorders
    • Embolism and thrombosis
    • Heart valve prosthesis implantation
    • Stroke

    Fingerprint

    Dive into the research topics of 'The Silent and apparent neurological injury in transcatheter aortic valve implantation study (SANITY): concept, design and rationale'. Together they form a unique fingerprint.

    Cite this