Cognitive Function after Transcatheter and Mini-Aortic Valve Replacement: A Multicenter Prospective Cohort Study
Bibliographic record
Abstract
Introduction: Recent retrospective analyses of randomized data suggest that cognitive decline after transcatheter (TAVR) and surgical aortic valve replacement (SAVR) are equivalent overall and may even improve in some populations. Yet, the change in neurocognitive function after minimally invasive aortic valve replacement remains yet to be clearly defined by prospective data. Methods: This is a prospective cohort study of patients undergoing mini-AVR (N=17) or TAVR (N=7) between 3/2020-12/2021. Baseline and postoperative neurocognitive status were assessed by Telephone-Montreal Cognitive Assessment (T-MoCA) and Activity Measure for Post-Acute Care-Applied Cognitive (AM-PAC-AC) scores. Results: Baseline cognitive status was higher among patients undergoing mini-AVR compared with TAVR (T-MoCA 20 vs 17 [p=0.013]; AM-PAC-AC 55 vs 44, [p=0.005]). Cognitive function declined postoperatively from baseline after mini-AVR when measured by T-MoCA (20 vs 19; p=0.007) but not by AM-PAC-AC Cognitive (55 vs 53; p=0.439). Cognitive function did not change postoperatively from baseline after TAVR (T-MoCA p=0.43; AM-PAC-AC Cognitive p=0.08). Decline in mental status was more pronounced after mini-AVR compared with TAVR using T-MoCA (-1.29 vs +0.86 [p=0.029]) but not by AM-PAC-AC (-2.44 vs -0.26; [p=0.5637]). At 180 days (n= 16), however, this difference was no longer significant by either T-MoCA (p=0.68) or AM-PAC-AC (p=0.23). Conclusion: There is a small early postoperative decline in neurocognitive function after open mini-AVR when compared with TAVR. There are many factors in the immediate postoperative phase that may influence cognitive assessment. Longer-interval follow-up planned in this study at 6 months and 1 year will provide a more robust assessment of cognitive changes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".