title: Imaging and functional testing to assess clinical and subclinical neurological events after transcatheter or surgical aortic valve replacement: a comprehensive review.
abstract: Neurological events after transcatheter (TAVR) or surgical aortic valve replacement (SAVR) are potentially devastating and associated with a poor prognosis. With technological improvements and increased operator experience, their incidence is markedly declining, justifying the need for surrogate endpoints to be used in future comparative trials. Moreover, imaging studies after TAVR and SAVR suggest that neurological events are mainly embolic in nature; however, there is significant discrepancy between imaging findings and clinically overt symptoms, raising the possibility of more subtle subclinical cognitive decline. Different modalities have been used to assess both overt and subclinical neurological events after SAVR and TAVR. The purpose of this report is to systematically review and describe currently used imaging, functional, and neurocognitive testing modalities and to better understand how they could be integrated in future prospective studies.
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
authors.forename: Marco
authors.initials: M
authors.lastname: Spaziano
authors.affiliation: Cardiovascular Research Foundation, New York, New York.
authors.forename: Dominic P
authors.initials: DP
authors.lastname: Francese
authors.affiliation: Cardiovascular Research Foundation, New York, New York; Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Cardiovascular Research Foundation, New York, New York; Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York. Electronic address: pgenereux@crf.org.
authors.forename: Philippe
authors.initials: P
authors.lastname: Généreux
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D006801:Humans; D059906:Neuroimaging / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis*; D015203:Reproducibility of Results; D020521:Stroke / Q000175:diagnosis*; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: neurological events; stroke; surgical aortic valve replacement; transcatheter aortic valve replacement