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TAVI – multidimensional early benefits on elderly patients
Session:
Posters (Sessão 3 - Écran 8) - Doença Valvular 3 - Válvula Aórtica
Speaker:
Ana Beatriz Garcia
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Beatriz Garcia; Nelson Cunha; Sara Couto Pereira; Pedro Silvério António; Pedro Alves da Silva; Joana Brito; Beatriz Valente Silva; Ana Margarida Martins; Catarina Simões de Oliveira; Ana Abrantes; João Fonseca; Catarina Gregório; Inês Ricardo; Fausto j. Pinto; Ana Abreu
Abstract
<p style="text-align:justify"><strong>Introduction:</strong> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Aortic stenosis is the most common valvular heart disease in Europe and in symptomatic patients, when untreated presents a high rate of morbidity and mortality. Its prevalence is estimated to grow even more, given the aging of the population. Transcatheter aortic valve implantation (TAVI) emerged as a safe and efficient procedure in patients with high or prohibitive surgical risk or in older patients, who are much often frailty, with impaired cognitive function and have poor quality of life.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> To assess the acute benefits (in 1 moth) of TAVI on cognitive function, anxiety and depression and independence in activities of daily living.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>Single center prospective study of patients submitted to TAVi between April 2021 and September 2021. Patients were evaluated at baseline (before TAVI) and one month after the procedure. To assess cognitive function, anxiety and depression and independence in activities of daily living we used the Mini Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS); Katz Index of Independence in Activities of Daily Living; and Lawton-Brody Instrumental Activities of Daily Living Scale, respectively. Paired sample t-test and Wilcoxon test were used to statistical analysis.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong>We included 20 patients, with a mean age of 85±5,86 years, 40% (8) male. 19 patients undergone TAVI due severe native aortic stenosis and 1 due to bioprosthetic aortic valve dysfunction. The vascular access site was transfemoral in 19 patients and transapical in 1 patient. The median MMSE results were higher 1 month after TAVI (21,3 versus 23,5, p=0,012), essentially due to a better results in the temporal orientation and evocation domains (p=0,011 and p=0,022, respectively). Patients experienced lower levels of anxiety and depression after TAVI, mean score 5,4 versus 3,9 (p=NS) and 7 versus 4,25 (p=0,002) respectively for anxiety and depression, as assessed by HADS scale. No statistical difference was observed on the results of basal and post TAVI evaluation of Katz and Lawton-Brody scales.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>In an elderly population, TAVI appears to have an early and beneficial effect (in 1 moth) on cognitive function and depression, but no benefits were observed on independence in activities of daily living. </span></span></p>
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