Health Beat

Health Beat: Sentinel protection for TAVR

Health Beat: Sentinel protection for...

LOS ANGELES - One of Robert Friedman's doctors described him as a "dead man walking" before he had his aortic valve replaced. He had several heart issues that made even non-invasive surgery dangerous and the risk of stroke highly possible. His cardiologist was able to get a new device for Friedman that gave him a new lease on life.

"I have felt great. I feel better than I've ever felt in my life. Tremendous energy. Gung ho. Just amazing," said Friedman, 73.

That wasn't the case for Friedman a year ago. He needed a heart valve replaced, but poor heart function and a clot in his left ventricle made that dangerous, even with a minimally-invasive procedure called TAVR.

Cardiologist Dr. Raj Makkar believed the sentinel cerebral protection system, or CPS, might protect Friedeman from stroke. About one in 10 TAVR patients suffers a stroke because of debris that's dislodged during the valve replacement and caught in the filters.

"These filters stay there while we are doing our work and changing the heart valve so that the debris hits the filter rather than actually going into the brain," explained Makkar, the director of interventional cardiology and cath lab at Cedars-Sinai Heart Institute.

Makkar inserts the sentinel through the arm, so it can catch debris and calcium dislodged during TAVR, then removes it. It adds about five minutes and reduces TAVR-related stroke by 63 percent in the first 72 hours.

"I think it's a good idea not to have debris go into the brain, even if it doesn't cause stroke," Makkar continued. "It might have some impact on the long-term health of the brain."

Friedman is just glad he can again stroll with his wife, Anita.

Makkar said the sentinel filter catches debris in most patients and will work for about 90 percent of patients needing TAVR. Doctors are trained to use the system at Cedars-Sinai, Emory University, the Cleveland Clinic, and Mount Sinai or New York Presbyterian.


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