Imaging and functional testing to assess clinical and subclinical neurological events after transcatheter or surgical aortic valve replacement

A comprehensive review

Marco Spaziano, Dominic P. Francese, Martin B. Leon, Philippe Genereux

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1950-1963
Number of pages14
JournalJournal of the American College of Cardiology
Volume64
Issue number18
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Aortic Valve
Surgical Instruments
Biomarkers
Prospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "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.",
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Imaging and functional testing to assess clinical and subclinical neurological events after transcatheter or surgical aortic valve replacement : A comprehensive review. / Spaziano, Marco; Francese, Dominic P.; Leon, Martin B.; Genereux, Philippe.

In: Journal of the American College of Cardiology, Vol. 64, No. 18, 01.01.2014, p. 1950-1963.

Research output: Contribution to journalReview article

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AU - Genereux, Philippe

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