According to the article “Stroke after Aortic Valve Surgery” published in Circulation the current number of clinical strokes after AVR were almost double of those previously stated in the Society of Thoracic Surgeries database. This makes one wonder why monitoring during and after AVR with Transcranial Doppler (TCD) is not an established requirement when performing the procedure.
Monitoring with TCD during AVR provides immediate feedback, allowing interventionalists to fine-tune their technique as it relates to the reduction of emboli which are precipitated by the procedure itself. Monitoring during recovery allows clinicians to quickly anticipate, identify, and treat post-procedural embolic stroke.
Transcranial Doppler monitoring during the AVR procedure and after is relatively inexpensive and easy to perform. Monitoring with TCD gives the physician immediate feed back during the intervention and should help prevent strokes and or allow for a quicker recovery. TCD monitoring will not only save or improve lives it will cut down on the number of added days stayed due to Stroke. This savings will more than justify the added cost of monitoring with TCD during and after an AVR procedure.
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