Cranial nerve injury during transcarotid transcatheter aortic valve replacement.

Background: No data exist about cranial nerve injury (CNI) as a potential complication of transcarotid (TC) transcatheter valve replacement (TAVR).

Methods: This monocentric study included 318 consecutive patients undergoing TC-TAVR from May 2015 to August 2021.

Results: CNI occurred in 7 (2.2%) TAVR-TC patients. Five out of the 7 patients (71.4%) had an injury of the laryngeal branch of the vagus nerve, and 2 patients (28.6%) had an injury of the facial nerve. The majority of patients were male (85.7%), with high body mass index (35.6 (IQR: 30.1-37.3) kg/m2). The induced disabilities were clinically important especially for patients with dysphonia.

Conclusions: CNI is a potential complication of TC-TAVR likely avoidable by a meticulous surgical technique. Structural heart teams must be aware of this serious setback.