Assessment of cognitive functions and quality of life in patients scheduled for transcatheter aortic valve implantation: a pilot study

Transcatheter aortic valve implantation (TAVI) is an innovative and effective treatment for patients with symptomatic severe aortic stenosis (AS). In particular, TAVI offers a treatment option for elderly patients with very high surgical risk, who are disqualified from surgical aortic valve replacement (SAVR) [1]. An improvement in long-term outcomes and quality of life (QoL) after TAVI has been confirmed by several studies [2–6]. Importantly, an exponential increase in the number of TAVIs is expected over the next decade. It is related to the aging of the population in Europe and the growing number of geriatric patients who will be possible candidates for TAVI. Apart from mortality, QoL and both mental and functional status are important instruments in assessing patient-specific outcomes of therapeutic interventions, especially in the population with limited life expectancy [7]. Measures of morbidity and mortality are not able to elucidate life-specific information on physical, emotional, and mental well-being but can be supplemented with the patient’s perception of recovery after the intervention [7]. However, there are specific changes in cognitive functioning, connected with aging [8]. Neuropsychological evaluation of cognitive functions and QoL assessment are helpful in the qualification process concerning clinical decisions and choice of treatment method. Furthermore, well-adjusted questionnaires are able to exclude those patients who cannot cooperate well enough during diagnostic procedures because of dementia. Identification of such patients would allow the Heart Team and treating physicians to better inform patients of their likely individual benefits from this procedure. Therefore, comprehensive medical and psychological evaluation of elderly patients seems to be necessary.
We sought to evaluate QoL in regard to both mental and functional status among patients with symptomatic severe AS scheduled for TAVI.
Here we summarize our initial results of 100 consecutive patients with symptomatic severe AS and high surgical risk or contraindications for SAVR. The periprocedural risk was evaluated with the STS PROM scale and EuroSCORE II. Patients were admitted for TAVI qualification to the Second Department of Cardiology and Cardiovascular Interventions in Krakow between 2016 and 2017. Patient screening and selection were performed by a multidisciplinary Heart Team. The study is planned to be held in three steps: assessment before the...


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