Cerebral Air Embolism Risks in TAVR Procedures: Insights from a 75-Year-Old Patient Case.

Abstract

BACKGROUND Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure increasingly used to treat severe aortic stenosis, especially in elderly patients and those with significant comorbidities who are at high risk for surgical intervention. While TAVR is generally safe and effective, rare complications can occur, including cerebral air embolism, which can result in acute neurological deficits. This report presents the case of a 75-year-old man who developed a cerebral air embolism following TAVR. CASE REPORT A 75-year-old man with severe aortic stenosis and comorbidities, including atrial fibrillation, prior stroke, diabetes mellitus, and coronary artery disease, underwent transfemoral TAVR. After the procedure, he experienced sudden neurological symptoms, including left-sided visual field loss, facial droop, and limb weakness. Neurological evaluation revealed an NIHSS score of 10, with dysarthria and right gaze preference. Imaging studies identified an air embolism in the right posterior cerebral artery, resulting in an infarction in the posterior cerebral artery territory. Supportive care was provided, and the patient was later transferred to a rehabilitation service for further recovery. CONCLUSIONS Cerebral air embolism is a rare but potentially serious complication of TAVR. Prompt recognition, the use of advanced imaging techniques, and appropriate management are critical in minimizing neurological damage and improving clinical outcomes. This case highlights the importance of procedural vigilance, strict adherence to air-purging protocols, meticulous device handling, and increased awareness among clinicians performing TAVR. Awareness of such rare but significant complications is essential to ensure optimal patient safety.