Lambl's excrescence in transcatheter aortic valve implantation: prevalence and risk of embolic events

Lambl's excrescences in transcatheter aortic valve implantation: a word of caution on the way to tailored and individualized approach

“…4 Transcatheter aortic valve implantation (TaVi) has become over the years a standard care treatment for patients with severe aortic valve stenosis ranging from patients with high operative risks to patients at intermediate operative risk, based on the favorable results of dedicated clinical trials and according to the most recent guidelines of the european Society of Cardiology/european association of Cardio-Thoracic Surgery (eSC/eaCTS). 5 in the present issue of Minerva Cardiology and Angiology Cammalleri et al 6 evaluated the prevalence of les and the rate of embolism in patients with aortic valve stenosis scheduled for TaVi. despite the assumed high risk of embolism, the study did not highlight an increase in the rate of cerebral ischemic events as well as other TaVi related complications in patients with les.…”

“…despite the assumed high risk of embolism, the study did not highlight an increase in the rate of cerebral ischemic events as well as other TaVi related complications in patients with les. 6 The idea of this retrospective study opens the way for a debate. First, several factors can contribute to an increased risk of stroke with TaVi: factors related to the procedure (native valve fragmentation with exposure to thrombogenic material, release of large amounts of tissue factor and individualized approach to the disease with the use, for instance, of cerebral protection device for these patients carrying a high embolic risk.…”