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Introduction: The best techniques for reduction of femoral access site complications after transcatheter aortic valve implantation (TAVI) remain the object of research. Aim: We report on a single center's experience with TAVI performed via the femoral access site. Material and methods: Between September 2010 and September 2015, 152 consecutive patients underwent TAVI in our department. Of them, 101 patients with CoreValve implantation from the femoral access site were included in the analysis. The femoral artery anatomy-tailored approach was introduced in 2013 in order to reduce the rate of access-site complications. Patients were assigned to percutaneous puncture or surgical cut-down depending on the femoral artery anatomy assessed in computed tomography. The study patients were divided into two subgroups: group A - patients treated before January 2013, before introduction of the tailored approach program (n = 34); and group B - patients treated between January 2013 and April 2015 (n = 67). Results: The access site complication rate significantly decreased from 35.3% in group A (n = 12) to 7.5% in group B (n = 5) (p = 0.0012). Both minor and major access site complications were more frequent in group A (p = 0.04 and 0.016, respectively). In-hospital mortality was 8.8% (n = 3) in group A and 1.5% (n = 1) in group B (p = 0.1). Conclusions: The femoral artery anatomy-tailored approach significantly reduces the incidence of access site complications in TAVI patients. [ABSTRACT FROM AUTHOR]

Aortic stenosis is the most commonly acquired valvular heart disease in developed countries. Although surgical aortic valve replacement remains the gold standard of treatment, in a number of patients with high perioperative risk, transcatheter aortic valve implantation (TAVI) is the preferred method. Embolic events involving the central nervous system may cause complications in TAVI and may worsen its results. Tests performed using DW-MRI suggest that TAVI, like other cardiac and cardiac surgery procedures, is fraught with increased risk of microemboli. The impairment of the vascular flow to brain tissue may lead to damage of brain structures, which in turn might result in brain disorders. Aware of these risks in patients requiring aortic valve implantation, medical personnel performing such procedures are impelled to monitor the severity of brain impairment, whereas the steady technological progress in the field of methods and systems of this endovascular procedure aims at reducing the number of complications, including the protection of the central nervous system. An important, albeit poorly understood, issue is the assessment of the cognitive function in both the perioperative and postoperative period in patients undergoing the TAVI procedure. This paper highlights two aspects - the deterioration of cognitive functions due to perioperative impairment of blood supply to the central nervous system and their potential augmentation resulting from postoperative hemodynamic improvement. Nevertheless, the influence of TAVI on cognitive disorders remains unclear and requires further research. [ABSTRACT FROM AUTHOR]

The rapid development of new technologies has caused interest in the use of socially assistive robots in the care of older people. These devices can be used not only to monitor states of health and assist in everyday activities but also to counteract the deterioration of cognitive functioning. The aim of the study was to investigate the attitudes and preferences of Polish respondents towards interventions aimed at the preservation/improvement of cognitive functions delivered by a socially assistive robot. A total of 166 individuals entered the study. Respondents completed the User's Needs, Requirements and Attitudes Questionnaire; items connected to cognitive and physical activity and social interventions were analyzed. Perceptions and attitudes were compared by gender and age groups (older adults ≥ 60 years old and younger adults 20–59). Women showed a more positive attitude towards robots than men and had a significantly higher perception of the role of the robots in reminding about medications (p = 0.033) as well as meal times and drinks (p = 0.018). There were no significant differences between age groups. Respondents highly valued both the traditional role of the robot—a reminding function—as well as the cognitive interventions and guided physical exercises provided by it. Our findings point to the acceptance of the use of socially assistive robots in the prevention of cognitive deterioration in older people. [ABSTRACT FROM AUTHOR]