A randomised trial of carbon dioxide flushing to reduce vascular brain injury in patients undergoing TAVI

BACKGROUND: ) flushing of the TAVI valves could reduce the incidence of new neurological lesions post-TAVI. AIMS: flushing in TAVI patients. METHODS: versus conventional saline on neurological outcomes post-TAVI, assessed using magnetic resonance imaging (MRI) and transcranial Doppler (TCD). Patients with aortic stenosis were randomised after obtaining vascular access. Periprocedural TCD assessed solid and gaseous emboli to the brain. Post-procedure, patients underwent brain MRI to detect lesions. Here, we report the primary outcome of feasibility, as well as the secondary MRI and mechanistic TCD outcomes. RESULTS: arm, primarily due to a reduction in gaseous emboli, but this difference was not statistically significant (p=0.5). CONCLUSIONS: flushing is an accessible, cost-effective method that can be easily implemented in any catheter laboratory to provide neurological advantages.