Prediction of the development of delirium after transcatheter aortic valve implantation using preoperative brain perfusion SPECT

Masashi Takeuchi, Hideaki Suzuki, Yasuharu Matsumoto, Yoku Kikuchi, Kentaro Takanami, Toshihiro Wagatsuma, Jun Sugisawa, Satoshi Tsuchiya, Kensuke Nishimiya, Kiyotaka Hao, Shigeo Godo, Tomohiko Shindo, Takashi Shiroto, Jun Takahashi, Kiichiro Kumagai, Masahiro Kohzuki, Kei Takase, Yoshikatsu Saiki, Satoshi Yasuda and Hiroaki Shimokawa

PLOS ONE, 2022, vol. 17, issue 11, 1-14

Abstract: Objectives: Delirium is an important prognostic factor in postoperative patients undergoing cardiovascular surgery and intervention, including transcatheter aortic valve implantation (TAVI). However, delirium after transcatheter aortic valve implantation (DAT) is difficult to predict and its pathophysiology is still unclear. We aimed to investigate whether preoperative cerebral blood flow (CBF) is associated with DAT and, if so, whether CBF measurement is useful for predicting DAT. Methods: We evaluated CBF in 50 consecutive patients before TAVI (84.7±4.5 yrs., 36 females) using 99mTc ethyl cysteinate dimer single-photon emission computed tomography. Preoperative CBF of the DAT group (N = 12) was compared with that of the non-DAT group (N = 38) using whole brain voxel-wise analysis with SPM12 and region of interest-based analysis with the easy-Z score imaging system. Multivariable logistic regression analysis with the presence of DAT was used to create its prediction model. Results: The whole brain analysis showed that preoperative CBF in the insula was lower in the DAT than in the non-DAT group (P

Date: 2022
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0276447

DOI: 10.1371/journal.pone.0276447

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