IMPACT OF DURATION OF TRANSCATHETER AORTIC VALVE IMPLANTATION ON NEUROPHYSIOLOGICAL OUTCOMES OF PATIENTS AFTER THE INTERVENTION

Highlights For the first time we have established an association between a prolonged duration of aortic valve implantation and deterioration of memory and attention, as well as a lower frequency of alpha activity, which indicates adverse changes in neural network activity. Abstract Aim . To examine the neurophysiological parameters of patients who underwent transcatheter aortic valve implantation (TAVI), taking into account the intervention's duration. Methods. The prospective study involved 53 patients, 13 of whom were men. All patients were divided into two groups depending on the duration of TAVI: up to 90 min (n = 21) and more than 90 min (n = 32). To determine the state of brain function in patients who underwent TAVI, preoperative cognitive screening, extended neuropsychological testing to determine postoperative cognitive dysfunction (POCD), and electroencephalographic (EEG) study 1–2 days before and 5–7 days after TAVI were conducted. Results. The majority of patients (83%) had a decreased preoperative cognitive status (36% severe, 47% moderate cognitive impairment). Extended neuropsychological testing at 5–7 days after TAVI demonstrated that the patients with a longer TAVI time had worse adaptation and greater exhaustion of the directed attention system, and remembered fewer words than the patients with an intervention time of less than 90 minutes. The patients with a longer TAVI time had a lower central frequency of EEG activity (alpha peak) at 5–7 days after TAVI than those with a shorter intervention time. The duration of TAVI has a statistically significant negative correlation with the central frequency of EEG activity. Conclusion. The results of the study demonstrated the significance of TAVI duration as a complex indicator, possibly associated with the features of the intervention, such as mechanisms of material embolism and impaired cerebral perfusion. The identification of specific perioperative factors and mechanisms that contribute to brain damage and POCD should be the focus of further investigation into TAVI patients' neurophysiological state.