Periprocedural Changes in Cognitive Function after Transcatheter and Surgical Aortic Valve Replacement: Results from a Pilot Study Assessing Cognition in Elderly Veterans
Wednesday, May 22, 2019
Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)
Santiago Garcia, M.D., FSCAI
,
Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Edina, MN
Laura Hemmy, PhD
,
Minneapolis VA Medical Center and University of Minnesota, Minneapolis, MN
Howard Fink, MD, MPH
,
Minneapolis VA Medical Center and University of Minnesota, Minneapolis, MN
Background:
There is paucity of comparative data assessing periprocedural changes in cognitive function with surgical (SAVR) and transcatheter (TAVR) aortic valve replacement.
Methods:
We enrolled patients with severe aortic stenosis scheduled to undergo TAVR or SAVR at the discretion of the heart team. Participants completed a cognitive battery before and 3 months after aortic valve replacement (AVR): Montreal cognitive assessment, phonemic verbal fluency, semantic verbal fluency, and trail making test A and B. Cognitive testing was conducted by a trained research nurse. Periprocedural differences in cognition were assessed within each group using the paired samples t-test or Wilcoxon test depending on the distribution of the data. For non-normally distributed data we report median and interquartile range and median and 95% confidence intervals for paired comparisons. The study is registered in Clinicaltrials.gov, NCT02971020.
Results:
63 patients (95% male) were included. Patients undergoing TAVR were older and more likely to have a history of coronary artery bypass graft surgery and chronic obstructive pulmonary disease but had similar surgical risk and aortic stenosis severity (
Table 1). The results of cognitive tests before and after TAVR and SAVR are presented in
Table 2.
Conclusions:
In this pilot study we observed no significant changes in cognition 3 months after SAVR or TAVR.
