Significant Association of Cognitive Function With Long-Term Clinical Outcomes After Transcatheter Aortic Valve Implantation: A Retrospective Cohort Study.

Background Patients undergoing transcatheter aortic valve implantation (TAVI) are often elderly, and perioperative and long-term risk assessments should primarily consider cognitive function, comorbidities, and procedural complexity. This study investigated the association between cognitive function and mortality in patients with severe aortic valve stenosis (AS) who underwent TAVI. Methodology This single-center, retrospective cohort study consecutively registered patients who underwent TAVI between December 2014 and December 2018. We divided the patients into two groups using a Mini-Mental State Examination (MMSE) score of 23. All-cause mortality was the primary outcome of this study. Results The study cohort included 114 patients with a follow-up period of five years. The mean age of the patients was 85 years. Overall, 37 of the 104 patients who underwent preoperative MMSE tests were considered to have cognitive impairment. The risk of all-cause death after TAVI was significantly higher in patients with impaired cognitive function than in those with preserved cognitive function (hazard ratio = 4.27; 95% confidence interval = 1.90-9.57). However, there were no significant differences in the function of the left ventricle and prosthetic aortic valve between the groups. Conclusions Impaired cognition significantly and independently affected the long-term outcomes of patients with severe AS who underwent TAVI. Given the age of the patients in this study, the indications for TAVI should be carefully considered for each patient based on their cognitive function.