Cognitive Outcomes following Transcatheter Aortic Valve Implantation: A Systematic Review

Table 1

Summary of studies measuring global cognition after TAVI using the MMSE.

Study		Type of TAVI	Baseline	After procedure	1-month F/U	3-month F/U
Orvin et al., 2014 [8]	36	TF (MCV) = 31; TA (MCV) = 5	25.9 ± 3.3	—	27.6 ± 2.4; < 0.001	—
Ghanem et al., 2013 [6]	111	TF (MCV) = 95; TF (ES) = 16	25.4 ± 3.4	25.4 ± 3.3^a; 25.1 ± 3.8^b; = 0.58	—	—
Kahlert et al., 2012 [9]	83	Overall	27.9; (27.5–28.3)	27.7; (27.3–28.2); = 0.521	—	28.3; (28.0–28.7); < 0.001
		TF (MCV) = 32	28.0; (27.5–28.5)	27.7; (27.3–28.2); = 0.488	—	28.4; (27.9–28.9); = 0.083
		TF (ES) = 26	27.3; (26.1–28.6)	27.6; (26.4–28.7); = 0.400	—	28.1; (27.0–29.1); = 0.003
		TA (ES) = 25	28.3; (27.8–28.8)	28.0; (27.4–28.5); = 0.256	—	28.6; (28.1–29.0); = 0.096
Knipp et al., 2013 [10]	27	TA (ES) = 27		−0.72 ± 1.42^c; > 0.05	—	0.95 ± 1.20^c; < 0.05
Rodés-Cabau et al., 2011 [11]	60	TF (ES) = 29; TA (ES) = 31	28; (17–30)	28; (16–30); = 0.14	—	—
Kahlert et al., 2010 [12]	32	TF (MCV) = 10	28.9; (28.2–29.6)	28.0; (27.0–29.0); > 0.05	—	28.9; (28.0–29.0); > 0.05
		TF (ES) = 22	28.1; (26.7–29.5)	28.3; (27.1–29.6); > 0.05		28.1; (26.7–29.7); > 0.05

= number, TAVI = transcatheter aortic valve implantation, MMSE = mini-mental status examination, TF = transfemoral, TA = transapical or transaxillary, ES = Edwards-SAPIEN, MCV = Medtronic CoreValve, and F/U = follow-up.
All studies were observational prospective cohort study. values are for MMSE scores from the specified time-point compared to baseline unless otherwise stated. Normal score for MMSE is 24 or above.
^aSubgroup with no risk of cognitive decline.
^bSubgroup with risk of cognitive decline.
^cChange in -score after procedure to follow-up.