BACKGROUND: There is paucity of data comparing periprocedural changes in cognitive function between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).
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 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.
RESULTS: 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).
CONCLUSIONS: In this pilot observational study, we observed no significant differences in cognition at baseline or 3 months between SAVR and TAVR groups.
|Original language||English (US)|
|Number of pages||6|
|Journal||The Journal of invasive cardiology|
|State||Published - Jan 2020|
Bibliographical noteFunding Information:
Funding: This study was supported by the Minnesota Veterans Research Foundation.
Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Garcia reports grant support from Boston Scientific; consultant income from Edwards Lifesciences, Medtronic, and Abbott Vascular. The remaining authors report no conflicts of interest regarding the content herein.
© 2020 HMP Communications. All rights reserved.
- Cognitive function
- Phonemic fluency
- Semantic fluency