Author + information
- Masieh Abawi1,
- Freek Nijhoff2,
- Pierfrancesco Agostoni3,
- Rehana de Vries4,
- Arjen Slooter5,
- Marielle Emmelot-Vonk6,
- Michiel Voskuil7,
- Jeroen Hendrikse8,
- Tim Leiner9,
- Pieter Doevendans10 and
- Pieter Stella11
- 1UMC Utrecht, Utrecht, Netherlands
- 2UMC Utrecht, Utrecht, Netherlands
- 3St. Antonius Hospital, Nieuwegein, Netherlands
- 4UMC Utrecht
- 5UMC Utrecht
- 6UMC Utrecht
- 7UMC Utrecht
- 8UMC Utrecht
- 9UMC Utrecht
- 10University Medical Center Utrecht, Utrecht, Netherlands
- 11University Medical Center Utrecht, Utrecht, Netherlands
New cerebral ischemic lesions are frequently detected with diffusion weighted magnetic resonance imaging (DWI-MRI) after transcatheter aortic valve Implantation (TAVI). Recent literature has shown that postoperative delirium(POD) occurs frequently after TAVI. Aim of this study is to investigate the relation between new cerebral ischemic injury evaluated by DWI and the occurrence of POD following TAVI.
All TAVI patients participating in prospective studies in our institute that involved post-procedural cerebral DWI were identified. Periprocedural, clinical and imaging data were prospectively collected. Cerebral DWI was performed within 5 days after TAVI. The occurrence of POD was assessed using the Delirium Observational Scale based on Diagnostic and Statistical Manual of Mental Disorder, 4rd Edition criteria.
Post-procedural cerebral DWI was performed in 103 patients (80±8 years, logistic EuroSCORE 17±9%). Postoperatively, DWI-lesions were observed in 90% (n=93) patients. Overall incidence of in hospital POD was 14.5% (n=15). The number of new cerebral DWI-lesions was higher in patients with POD (8[5-15] vs.4 [2-7], p=0.023). After controlling for several confounding factors (i.e., global cortical atrophy, white matter abnormalities, logistic EuroSCORE, access site), the number of DWI-lesions remained significantly associated with POD (Odds Ratio 1.08; 95% confidence interval 1.10-1.16, per number of DWI-lesions increase).
The incidence of new cerebral DWI-lesions after TAVI is high; a higher number of these lesions is associated with a higher incidence of postoperative delirium following TAVI.
STRUCTURAL: Valvular Disease: Aortic