Stroke After Transcatheter Aortic Valve Replacement With Contemporary Valves: Insights From the OCEAN-TAVI Registry

@article{yusukewatanabe2026stroke,
  title = {{Stroke After Transcatheter Aortic Valve Replacement With Contemporary Valves: Insights From the OCEAN-TAVI Registry}},
  author = {Yusuke Watanabe, MD and Masanori Yamamoto, MD and Hirofumi Hioki, MD and Masafumi Saito, MD and Jo Omiya, MD and Kento Kito, MD and Yasuyuki Tsuchida, MD and Yosei Iseki, MD and Masataka Arakawa, MD and Mizuki Miura, MD and Akihisa Kataoka, MD and Takahiro Tokuda, MD and Shinichi Shirai, MD and Kenichi Ishizu, MD and Toru Naganuma, MD and Futoshi Yamanaka, MD and Masahiko Noguchi, MD and Yohei Ohno, MD and Tetsuro Shimura, MD and Fumiaki Yashima, MD and Gaku Nakazawa, MD and Masahiko Asami, MD and Masaki Izumo, MD and Hidetaka Nishina, MD and Hiroshi Ueno, MD and Hiroto Suzuyama, MD and Kazumasa Yamasaki, MD and Kenji Nishioka, MD and Daisuke Hachinohe, MD and Yasushi Fuku, MD and Toshiaki Otsuka, MD and Kentaro Hayashida, MD},
  journal = {Structural Heart},
  year = {2026},
  month = jul,
  doi = {10.1016/j.shj.2026.101099},
  url = {https://doi.org/10.1016/j.shj.2026.101099},
  note = {CC BY},
}

TY  - JOUR
TI  - Stroke After Transcatheter Aortic Valve Replacement With Contemporary Valves: Insights From the OCEAN-TAVI Registry
AU  - Yusuke Watanabe, MD
AU  - Masanori Yamamoto, MD
AU  - Hirofumi Hioki, MD
AU  - Masafumi Saito, MD
AU  - Jo Omiya, MD
AU  - Kento Kito, MD
AU  - Yasuyuki Tsuchida, MD
AU  - Yosei Iseki, MD
AU  - Masataka Arakawa, MD
AU  - Mizuki Miura, MD
AU  - Akihisa Kataoka, MD
AU  - Takahiro Tokuda, MD
AU  - Shinichi Shirai, MD
AU  - Kenichi Ishizu, MD
AU  - Toru Naganuma, MD
AU  - Futoshi Yamanaka, MD
AU  - Masahiko Noguchi, MD
AU  - Yohei Ohno, MD
AU  - Tetsuro Shimura, MD
AU  - Fumiaki Yashima, MD
AU  - Gaku Nakazawa, MD
AU  - Masahiko Asami, MD
AU  - Masaki Izumo, MD
AU  - Hidetaka Nishina, MD
AU  - Hiroshi Ueno, MD
AU  - Hiroto Suzuyama, MD
AU  - Kazumasa Yamasaki, MD
AU  - Kenji Nishioka, MD
AU  - Daisuke Hachinohe, MD
AU  - Yasushi Fuku, MD
AU  - Toshiaki Otsuka, MD
AU  - Kentaro Hayashida, MD
PY  - 2026
DA  - 2026/07/22
JO  - Structural Heart
DO  - 10.1016/j.shj.2026.101099
UR  - https://doi.org/10.1016/j.shj.2026.101099
AB  - Background: Stroke remains a serious complication after transcatheter aortic valve replacement (TAVR), even with contemporary devices. The objective of the study was to evaluate the incidence, predictors, and prognosis of in-hospital stroke in patients undergoing TAVR with contemporary valve platforms. Methods: We analyzed 5123 patients from the multicenter OCEAN-TAVI registry who underwent TAVR with SAPIEN 3 Ultra RESILIA, Evolut FX, or Navitor between May 2022 and December 2024. Stroke incidence across valve types was compared using inverse probability of treatment weighting (IPTW). Predictors were assessed using multivariable Firth penalized logistic regression. Results: In-hospital stroke occurred in 2.5% of patients. After IPTW adjustment, stroke incidence differed among valve types: 1.7% of patients treated with SAPIEN 3 Ultra RESILIA (S3UR), 4.5% with Evolut FX, and 2.4% with Navitor ( p = 0.044). Disabling stroke was more frequent with Evolut FX (2.5%) compared with S3UR (0.4%) and Navitor (0.7%; p < 0.001). Self-expanding valve use (adjusted odds ratio [aOR] 2.64, 95% CI 1.67–4.16 for Evolut FX; aOR 2.37, 95% CI 1.35–4.18 for Navitor; both vs. S3UR), prior stroke (aOR 1.83, 95% CI 1.19–2.73), reduced renal function, and nontransfemoral access (aOR 2.11, 95% CI 1.29–3.45) were independently associated with in-hospital stroke. One-year survival was significantly lower among patients with stroke than among those without stroke (73.0% vs. 90.3%; p < 0.001). Conclusions: In-hospital stroke remains an important complication after contemporary TAVR and is associated with worse clinical outcomes. Differences in stroke incidence across valve types were observed, highlighting the need for improved risk assessment.
SN  - 2474-8706
SN  - 2474-8714
ER  -