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. ±. 6. years, 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.