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Published on: August 8, 2025
Evolution of Cognitive Function After Transcatheter Aortic Valve Implantation
Andreas W Schoenenberger1, Chantal Zuber2, André Moser2
1From the Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Switzerland (A.W.S., C.Z., A.M., A.E.S.); Institute of Social and Preventive Medicine, University of Bern, Switzerland (A.M., M.Z.); Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Switzerland (P.W., S.W., S.S.); and Department of Cardiovascular Surgery, Swiss Cardiovascular Center Bern, Bern University Hospital, Switzerland (T.C.). Andreas.Schoenenberger@insel.ch.
Transcatheter aortic valve implantation (TAVI) may improve cognitive function in older adults with severe aortic stenosis, particularly those with pre-existing cognitive impairment. However, some patients may experience cognitive decline post-procedure.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Conflicting results exist regarding cognitive function changes after transcatheter aortic valve implantation (TAVI).
- Assessing cognitive function evolution post-TAVI is crucial for understanding patient outcomes.
Purpose of the Study:
- To evaluate cognitive function changes in patients undergoing TAVI.
- To identify factors influencing cognitive outcomes after TAVI.
Main Methods:
- Prospective cohort study of 229 patients aged 70+ years.
- Cognitive function assessed using Mini Mental State Examination (MMSE) pre- and 6-months post-TAVI.
- Cognitive deterioration defined as ≥3-point MMSE decrease; improvement as ≥3-point increase.
Main Results:
- Cognitive deterioration occurred in 12.7% of patients; no significant predictors identified.
- Specific causes for severe decline (≥5 points) found in 6 of 8 patients (e.g., delirium, stroke).
- Among 48 patients with impaired baseline cognition, 37.5% showed improvement; lower baseline aortic valve area correlated with improvement.
Conclusions:
- TAVI may lead to cognitive improvement in patients with pre-existing cognitive impairment, potentially due to hemodynamic effects.
- Cognitive deterioration can occur post-TAVI, necessitating further investigation into underlying causes.
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