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Updated: May 6, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Cognitive trajectory after transcatheter aortic valve implantation
Alexander Ghanem1, Justine Kocurek, Jan-Malte Sinning
1From the Department of Medicine/Cardiology (A.G., J.K., J.-M.S., B.V.B., M.V., T.S., M.V.-N., C.H., J.O.S., N.W., E.G., G.N.), Department of Psychiatry and Psychotherapy (M.W., S.W.), and Department of Radiology (D.T., A.M.), University of Bonn, Bonn, Germany; and German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany (M.W., S.W.).
Cognitive function generally remains stable after transcatheter aortic valve implantation (TAVI), with most patients showing preserved performance. Advanced age is the primary factor linked to cognitive decline post-TAVI.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Transcatheter aortic valve implantation (TAVI) is linked to silent cerebral injury, potentially impacting cognitive function.
- Investigating cognitive changes after TAVI is crucial due to its increasing prevalence.
Purpose of the Study:
- To longitudinally assess cognitive trajectory in patients undergoing TAVI.
- To identify factors associated with cognitive decline or preservation post-TAVI.
Main Methods:
- Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status at multiple time points up to 2 years post-TAVI.
- Brain injury was assessed using diffusion-weighted MRI.
- Patient age, procedural data, and neuroprotective strategies were analyzed for their impact on cognition.
Main Results:
- Global cognitive function showed a transient increase early after TAVI, returning to baseline levels by 3 months and remaining stable.
- Only 5.4% of patients experienced early cognitive decline, with infrequent persistence or late onset.
- The majority of patients (91%) maintained stable cognitive performance over 2 years.
- Advanced patient age was the sole independent predictor of cognitive decline post-TAVI.
Conclusions:
- Cognitive performance is largely preserved in most patients within 2 years following TAVI.
- Age is a significant factor influencing cognitive outcomes after TAVI, despite the procedure's risks.
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