Author + information
- Received May 13, 2014
- Revision received June 15, 2014
- Accepted July 15, 2014
- Published online November 4, 2014.
- Marco Spaziano, MD∗,
- Dominic P. Francese, MPH†,
- Martin B. Leon, MD†,‡ and
- Philippe Généreux, MD∗,†,‡∗ ()
- ∗Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- †Cardiovascular Research Foundation, New York, New York
- ‡Columbia University Medical Center/New York–Presbyterian Hospital, New York, New York
- ↵∗Reprint requests and correspondence:
Dr. Philippe Généreux, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 Boulevard Gouin Ouest, Montréal, Québec H4J 1C5, Canada.
Neurological events after transcatheter (TAVR) or surgical aortic valve replacement (SAVR) are potentially devastating and associated with a poor prognosis. With technological improvements and increased operator experience, their incidence is markedly declining, justifying the need for surrogate endpoints to be used in future comparative trials. Moreover, imaging studies after TAVR and SAVR suggest that neurological events are mainly embolic in nature; however, there is significant discrepancy between imaging findings and clinically overt symptoms, raising the possibility of more subtle subclinical cognitive decline. Different modalities have been used to assess both overt and subclinical neurological events after SAVR and TAVR. The purpose of this report is to systematically review and describe currently used imaging, functional, and neurocognitive testing modalities and to better understand how they could be integrated in future prospective studies.
Dr. Leon has received travel reimbursements from Edwards Lifesciences related to his activities as an unpaid member of the PARTNER Executive Committee. Dr. Généreux has received speaker’s fees from Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 13, 2014.
- Revision received June 15, 2014.
- Accepted July 15, 2014.
- American College of Cardiology Foundation