YOUR HEALTH: Stopping a stroke with a filter

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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 Robert that gave him a new lease on life.

"I have felt great," he said.  "I feel better than I've ever felt in my life."

"Tremendous energy.  Gung ho.  Just amazing."

That wasn't the case for 73-year-old Robert 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, a transcatheter aortic valve replacement.

Cardiologist Dr. Raj Makkar believed the newly created Sentinel Cerebral Protection System, or CPS, might protect Robert from stroke.   About one in 10 TAVR patients suffer stroke because debris can be 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 Dr. Makkar, a cardiologist from Cedars-Sinai Medical Center.

Dr. Makkar inserts the Sentinel through the arm, so they can catch debris and calcium dislodged during TAVR, then removes them.   It adds about five minutes and reduced TAVR-related stroke by 63% 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," said Dr. Makkar.

"It might have some impact on the long-term health of the brain."

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

BACKGROUND: TAVR is a minimally-invasive surgical procedure that repairs the aortic valve without removing the old, damaged one. Instead, the replacement is wedged into place. The full name for this procedure is a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI). Similar to a stent placed in an artery, this approach delivers a fully collapsible replacement valve to the site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating the blood flow. This procedure is different from the standard valve replacement, it is fairly new and for those patients considered at intermediate or high risk for standard valve replacement.  (Source:

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at or Marjorie Bekaert Thomas at

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