Abstract 15486: The Incidence of Neurocognitive Deficits in Patients That Have Undergone Transcatheter Aortic Valve Replacement

• Published in: Circulation (New York, N.Y.) Vol. 138; no. Suppl_1 Suppl 1; p. A15486
• Main Authors: Qureshi, Reema O, Pomakov, Alexander, Gonda, Smitha, Sawant, Abhishek, Ramanan, Tharmathai, Khan, Suhoor, Iyer, Vijay, Bhardwaj, Aishwarya
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 06.11.2018
• ISSN: 0009-7322; 1524-4539

IntroductionTrans-catheter aortic valve replacement (TAVR) is considered standard of care for symptomatic severe aortic stenosis in patients with high-risk for surgery and is being increasingly utilized for those with intermediate risk as well. Recent literature has shown greater neuro-cognitive decline in the post-TAVR population as compared to the general population. However, those studies were limited by a small sample size or limited clinical outcome assessments. We attempt to objectively evaluate a decline in neurological function before and after a TAVR procedure.HypothesisIn patients undergoing TAVR, there is a decline in cognitive function (assessed as Mini-Mental State Exam (MMSE) score) after the TAVR procedure.MethodsPatients that undergo TAVR are routinely evaluated at pre-procedure and a 1 month follow up office visit. The MMSE questionnaire is administered as routine care at these visits. We prospectively enrolled the patients in the study and calculated the MMSE scores for analysis.ResultsAmong all patients (n = 106) the mean age was 82 ± 9 years, 98 (93)% were white and 53 (50%) were female. 13 patients (12.3%) had prior CVA and 36 (34%) had a history of atrial fibrillation out of which 26 patients were on anticoagulation. 50 patients (47.2%) were smokers, 87 (82.1%) had HTN, 34 (32.1%) had diabetes, 31 (29.2%) had CKD and 13 (12.3%) had a history of peripheral arterial disease. The median STS Risk Score among all patients was 5.35%.As shown in Figure 1, the median pre-procedure MMSE Score was 28 points (Interquartile Range24, 29) points. At 1 month follow up the MMSE Score was 28 points (Interquartile Range27,29 points), p value calculated by student t-test was 0.06.ConclusionsWe did not find a statistically significant difference in the MMSE scores before and after the TAVR procedure. In the second arm of our study, we intend to increase the power of the study using a larger sample size, use more sensitive tools to detect smaller differences, use multiple tools to increase the reliability of the results, and follow patients through to their 1 year follow up to assess insidious long-term cognitive function.