• Philipp C Seppelt, Silvia Mas-Peiro, Roberta De Rosa, Isabell M Murray, Mani Arsalan, Lars Holzer, Gösta Lotz, Patrick Meybohm, Kai Zacharowski, Thomas Walther, Andreas M Zeiher, Stephan Fichtlscherer, and Mariuca Vasa-Nicotera.
• Division of Cardiology, Department of Medicine III, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
• Catheter Cardiovasc Interv. 2021 Jan 1; 97 (1): E146-E153.

BackgroundCerebral O2 saturation (ScO2 ) reflects cerebral perfusion and can be measured noninvasively by near-infrared spectroscopy (NIRS).ObjectivesIn this pilot study, we describe the dynamics of ScO2 during TAVI in nonventilated patients and its impact on procedural outcome.Methods And ResultsWe measured ScO2 of both frontal lobes continuously by NIRS in 50 consecutive analgo-sedated patients undergoing transfemoral TAVI (female 58%, mean age 80.8 years). Compared to baseline ScO2 dropped significantly during RVP (59.3% vs. 53.9%, p < .01). Five minutes after RVP ScO2 values normalized (post RVP 62.6% vs. 53.9% during RVP, p < .01; pre 61.6% vs. post RVP 62.6%, p = .53). Patients with an intraprocedural pathological ScO2 decline of >20% (n = 13) had higher EuroSCORE II (3.42% vs. 5.7%, p = .020) and experienced more often delirium (24% vs. 62%, p = .015) and stroke (0% vs. 23%, p < .01) after TAVI. Multivariable logistic regression revealed higher age and large ScO2 drops as independent risk factors for delirium.ConclusionsDuring RVP ScO2 significantly declined compared to baseline. A ScO2 decline of >20% is associated with a higher incidence of delirium and stroke and a valid cut-off value to screen for these complications. NIRS measurement during TAVI procedure may be an easy to implement diagnostic tool to detect patients at high risks for cerebrovascular complications and delirium.© 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.

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