1. Evaluation of Cognitive Function Following Transcatheter Aortic Valve Replacement.
- Author
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Abawi, Masieh, de Vries, Rehana, Stella, Pieter R., Agostoni, Pierfrancesco, Boelens, Dirk H.M., van Jaarsveld, Romy C., van Dongen, Charlotte S., Doevendans, Pieter A.F.M., and Emmelot-Vonk, Mariëlle H.
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COGNITIVE ability , *AORTIC valve transplantation , *ADVERSE health care events , *CHEMOEMBOLIZATION , *VERBAL memory , *AORTIC stenosis , *COGNITION , *PROSTHETIC heart valves , *LONGITUDINAL method , *PSYCHOLOGICAL tests , *SURGICAL complications , *TIME , *TREATMENT effectiveness , *RETROSPECTIVE studies , *SEVERITY of illness index ,AORTIC valve surgery - 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. [ABSTRACT FROM AUTHOR]- Published
- 2018
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