Stroke remains an important complication after transcatheter aortic valve replacement (TAVR), but contemporary evidence from community hospitals has been limited. This registry analysis, published in JACC: Advances, assessed whether valve type was associated with stroke within 1 year after TAVR.

The analysis included patients treated between January 2021 and February 2023 across CommonSpirit Health hospitals using data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry. Valve platforms were categorized as balloon-expandable valves or self-expanding valves (SEV). Stroke-free survival was assessed using Kaplan-Meier methods, with weighted adjustment for baseline differences.

Among 6,663 patients, 5,445 (81.7%) received balloon-expandable valves and 1,218 (18.3%) received SEV. The SEV group included a higher proportion of women (56.7% vs 37.5%; P < 0.001) and a higher mean STS risk score (4.5 ± 3.8 vs 4.0 ± 3.5; P < 0.001).

Overall, 87 patients (1.3%) experienced stroke during follow-up. Stroke-free survival did not differ by valve type (log-rank P = 0.448). After adjustment, valve type was not associated with stroke (adjusted HR 1.54; 95% CI 0.79-2.68; P = 0.294). Older age, lower body mass index, prior stroke, higher STS risk, and alternative access were associated with stroke.

Valve platform selection did not appear to influence 1-year stroke risk. Baseline clinical risk factors were more strongly associated with stroke occurrence.