HSR&D Citation Abstract
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Garcia S, Hemmy LS, Kelly R, Fink HA. Periprocedural Changes in Cognitive Function After Transcatheter and Surgical Aortic Valve Replacement: Results From a Pilot Study Assessing Cognition in Elderly Veterans. The Journal of invasive cardiology. 2020 Jan 1; 32(1):12-17.
There is paucity of data comparing periprocedural changes in cognitive function between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).
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 TAVR or SAVR, including the Montreal Cognitive Assessment (MoCA), phonemic (letter) verbal fluency, semantic (category) verbal fluency, and the Trail Making test (TMT) A and B. Periprocedural differences in cognition were compared within (pre/post procedure) and between groups using the paired-samples or independent-sample t-test, respectively. The Wilcoxon test was used for non-normally distributed data.
Of the 63 patients (95% men) included, a total of 43 underwent TAVR and 20 underwent SAVR. Patients undergoing TAVR were older than SAVR patients (78 ± 8 years vs 70 ± 7 years, respectively; P < .001), but had similar STS surgical risk scores (4.9% vs 4.7%, respectively; P = .79). At baseline, there were no differences in cognition. At 3 months post TAVR or SAVR, there were no significant differences for MoCA blind score (16 ± 3 vs 16 ± 3, respectively; P = .61), correct responses in semantic fluency (15 ± 5 vs 15 ± 6, respectively; P = .93), correct responses in phonemic fluency (30 ± 12 vs 28 ± 15, respectively; P = .87), TMT A completion time (54 sec [IQR, 42-65 sec] vs 31 sec [IQR, 28-69 sec], respectively; P = .07), or TMT B completion time (161 sec [IQR, 118-300 sec] vs 173 sec [IQR, 110-300 sec], respectively; P = .87).
In this pilot observational study, we observed no significant differences in cognition at baseline or 3 months between SAVR and TAVR groups.