Neurological Complications After Transcatheter Aortic Valve Replacement: A Review.

Autor:	Mangold AS; From the Cooper Medical School of Rowan University, Camden, New Jersey., Benincasa S; From the Cooper Medical School of Rowan University, Camden, New Jersey., Sanders BM; From the Cooper Medical School of Rowan University, Camden, New Jersey., Patel K; From the Cooper Medical School of Rowan University, Camden, New Jersey.; Cooper University Healthcare, Camden, New Jersey., Mitrev L; From the Cooper Medical School of Rowan University, Camden, New Jersey.; Cooper University Healthcare, Camden, New Jersey.
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2024 Nov 01; Vol. 139 (5), pp. 986-996. Date of Electronic Publication: 2024 Aug 12.
DOI:	10.1213/ANE.0000000000007087
Abstrakt:	Transcatheter aortic valve replacement (TAVR) has become the dominant procedural modality for aortic valve replacement in the United States. The reported rates of neurological complications in patients undergoing TAVR have changed over time and are dependent on diagnostic definitions and modalities. Most strokes after TAVR are likely embolic in origin, and the incidence of stroke has decreased over time. Studies have yielded conflicting results when comparing stroke rates between TAVR and surgical aortic valve replacement (SAVR), especially due to differences in diagnostic criteria and neurocognitive testing. In this narrative review, we summarize the available data on the incidence of stroke, delirium, and cognitive decline after TAVR and highlight potential areas in need of future research. We also discuss silent cerebral ischemic lesions (SCILs) and their association with a decline in postoperative neurocognitive status after TAVR. Finally, we describe that the risk of delirium and postoperative decline is increased when nonfemoral access routes are used, and we highlight the need for standardized imaging and valid, repeatable methodologies to assess cognitive changes after TAVR. Competing Interests: Conflicts of Interest, Funding: See DISCLOSURES at the the end of this article. (Copyright © 2024 International Anesthesia Research Society.)
Databáze:	MEDLINE
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