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Article

Dementia Development during Long-Term Follow-Up after Surgical Aortic Valve Replacement with a Biological Prosthesis in a Geriatric Population

1
Faculty of Medicine, University of Antwerp, 2610 Antwerp, Belgium
2
Department Cardiovascular Surgery, ZNA Middelheim General Hospital, 2020 Antwerp, Belgium
*
Author to whom correspondence should be addressed.
J. Cardiovasc. Dev. Dis. 2024, 11(5), 136; https://doi.org/10.3390/jcdd11050136
Submission received: 19 March 2024 / Revised: 22 April 2024 / Accepted: 25 April 2024 / Published: 28 April 2024
(This article belongs to the Section Cardiac Surgery)

Abstract

Surgical aortic valve replacement (SAVR) with a biological heart valve prosthesis (BHV) is often used as a treatment in elderly patients with symptomatic aortic valve disease. This age group is also at risk for the development of dementia in the years following SAVR. The research question is “what are the predictors for the development of dementia?”. In 1500 patients undergoing SAVR with or without an associated procedure, preoperative (demographic, cardiac and non-cardiac comorbid conditions), perioperative (associated procedures, cross-clamp and cardiopulmonary bypass time) and postoperative 30-day adverse events (bleeding, thromboembolism, heart failure, conduction defects, arrhythmias, delirium, renal and pulmonary complications) were investigated for their effect on the occurrence of dementia by univariate analyses. Significant factors were entered in a multivariate analysis. The sum of the individual follow-up of the patients was 10,182 patient-years, with a mean follow-up of 6.8 years. Data for the development of dementia could be obtained in 1233 of the 1406 patients who left the hospital alive. Dementia during long-term follow-up developed in 216/1233 (17.2%) of the patients at 70 ± 37 months. Development of dementia reduced the mean survival from 123 (119–128) to 109 (102–116) months (p < 0.001). Postoperative delirium was the dominant predictor (OR = 3.55 with a 95%CI of 2.41–4.93; p < 0.00), followed by age > 80 years (2.38; 1.78–3.18; p < 0.001); preoperative atrial fibrillation (1.47; 1.07–2.01; p = 0.018); cardiopulmonary bypass time > 120 min (1.34; 1.02–1.78; p = 0.039) and postoperative thromboembolism (1.94; 1.02–3.70; p = 0.044). Postoperative delirium, as a marker for poor condition, and an age of 80 or more were the dominant predictors.
Keywords: surgical aortic valve replacement; dementia; predictors surgical aortic valve replacement; dementia; predictors

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MDPI and ACS Style

Deblier, I.; Dossche, K.; Vanermen, A.; Mistiaen, W. Dementia Development during Long-Term Follow-Up after Surgical Aortic Valve Replacement with a Biological Prosthesis in a Geriatric Population. J. Cardiovasc. Dev. Dis. 2024, 11, 136. https://doi.org/10.3390/jcdd11050136

AMA Style

Deblier I, Dossche K, Vanermen A, Mistiaen W. Dementia Development during Long-Term Follow-Up after Surgical Aortic Valve Replacement with a Biological Prosthesis in a Geriatric Population. Journal of Cardiovascular Development and Disease. 2024; 11(5):136. https://doi.org/10.3390/jcdd11050136

Chicago/Turabian Style

Deblier, Ivo, Karl Dossche, Anthony Vanermen, and Wilhelm Mistiaen. 2024. "Dementia Development during Long-Term Follow-Up after Surgical Aortic Valve Replacement with a Biological Prosthesis in a Geriatric Population" Journal of Cardiovascular Development and Disease 11, no. 5: 136. https://doi.org/10.3390/jcdd11050136

APA Style

Deblier, I., Dossche, K., Vanermen, A., & Mistiaen, W. (2024). Dementia Development during Long-Term Follow-Up after Surgical Aortic Valve Replacement with a Biological Prosthesis in a Geriatric Population. Journal of Cardiovascular Development and Disease, 11(5), 136. https://doi.org/10.3390/jcdd11050136

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