Comprehensive prospective cognitive and physical function assessment in elderly patients undergoing transcatheter aortic valve implantation.
OBJECTIVE
Transcatheter aortic valve implantation (TAVI) is occasionally associated with stroke and silent cerebral ischemia, which may affect cognitive and functional performance. The aim of this study was to evaluate the changes in cognitive performance and functional status following TAVI.


METHODS
We performed a comprehensive prospective functional, cognitive and quality of life (QOL) evaluation in consecutive patients who underwent TAVI using the CoreValve device (Medtronic Inc.). The evaluation was performed at baseline and 1 month after the procedure and included the 36-item Short-Form Health Survey for QOL assessment, Mini-Mental State Examination (MMSE), quantitative clock drawing test (Rouleau), color trails test, Cognistat evaluation, Barthel Index and Duke Activity Status Index.


RESULTS
A total of 36 patients completed the full pre- and post-TAVI evaluation. Mean age was 82.2 ± 4.2 years (52.8% men); 94.5% of patients had low functional class (New York Heart Association III/IV), and 13.9% had prior stroke. After the procedure, all patients had improved functional status and valve hemodynamics. At 1 month, there was a significant improvement in the MMSE and Cognistat evaluations (from 25.9 ± 3.3 to 27.6 ± 2.4, p < 0.001, and from 5 ± 1 to 5.7 ± 0.7, p = 0.001, respectively).


CONCLUSIONS
Our preliminary results of a comprehensive assessment of patients undergoing TAVI indicate favorable results for both functional performance and cognitive function early after the procedure.
Cardiology Department, Rabin Medical Center, Petach Tikva, Israel.
Katia
K
Orvin
Danny
D
Dvir
Avraham
A
Weiss
Abid
A
Assali
Hana
H
Vaknin-Assa
Yaron
Y
Shapira
Osnat
O
Gazit
Alex
A
Sagie
Ran
R
Kornowski
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology*; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006304:Health Status; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life