Evaluation of Cognitive Function Following Transcatheter Aortic Valve Replacement.

Abstract

BACKGROUND:

Transcatheter aortic valve replacement (TAVR) is associated with procedural-related neurological events and acute cognitive decline. However, data on the effect of TAVR on mid-term cognitive outcome are scarce. Therefore, we aimed to assess the impact of TAVR on mid-term cognitive outcome using different neurocognitive test batteries.

METHODS:

Patients with severe aortic valve stenosis scheduled for TAVR were enrolled. Cognitive assessment was performed at baseline and 4 months post-TAVR using an eight-word verbal-learning test ("Immediate Recall Memory Test" [IRMT], "Delayed Recall Memory Test" [DRMT], "Recognition of Verbal Information Test" [RVIT]), global cognitive function ("Mini Mental State Examination" [MMSE]), and executive function ("Trail Making Test" [TMT], "Clock-Drawing Test" [CDT]).

RESULTS:

A total of 30 patients (age: 81±6years, logistic EuroSCORE: 19±10%) completed the follow-up cognitive assessments. Postoperatively, 17% (n=5) developed delirium, 13% (n=4) received permanent pacemaker, and there were no cerebrovascular events. Mean hospital duration time was 5±2 days. Patients (n=22) who did not complete the follow-up cognitive assessments had comparable baseline, procedural and hospital outcome. At follow-up there was a significant improvement in IRMT (27±5 vs. 30±4, p=0.016), with a trend toward improved DRMT (4±2 vs. 5±2, p=0.079). Moreover, patients with lower baseline MMSE and IRMT improved significantly during the follow-up.

CONCLUSIONS:

Transcatheter aortic valve replacement was associated with an improved IRMT during follow-up. Both MMSE and IRMT were significantly improved among those with lower baseline scores.

• Authors: Masieh Abawi, Rehana de Vries, Pieter R Stella, Pierfrancesco Agostoni, Dirk H M Boelens, Romy C van Jaarsveld, Charlotte S van Dongen, Pieter A F M Doevendans, Mariëlle H Emmelot-Vonk
• Journal: Heart, lung & circulation (Heart Lung Circ) Vol. 27 Issue 12 Pg. 1454-1461 (Dec 2018) ISSN: 1444-2892 [Electronic] Australia
• PMID: 29097068 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Topics

• Aged, 80 and over
• Aortic Valve (surgery)
• Aortic Valve Stenosis (surgery)
• Cognition (physiology)
• Cognitive Dysfunction (diagnosis, etiology, physiopathology)
• Female
• Follow-Up Studies
• Humans
• Male
• Postoperative Complications
• Psychological Tests
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Time Factors
• Transcatheter Aortic Valve Replacement
• Treatment Outcome