Cerebral perfusion in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation

Despite the striking load of peri-procedural cerebral micro embolizations, cognitive functioning improves after transcatheter aortic valve replacement (TAVI). We hypothesize that the decreased cardiac output in patients with severe aortic valve stenosis leads to reduced cerebral blood flow which may be restored by TAVI. The objective of the current trial is to examine whether cerebral blood flow improves after TAVI. Moreover, predictors for an increase in cerebral blood flow will be evaluated. Fifty patients with severe aortic valve stenosis will undergo TAVI and prospective assessment of cerebral blood flow using arterial spin label magnetic resonance imaging (ASL-MRI) at baseline and 3 month follow-up. Moreover, the incidence of new white matter hyperintentsities will be evaluated. Finally, in a sub cohort, cerebral blood flow will be evaluated with transcranial Doppler (TCD) during rest, mild exercise and auto-regulation testing (cerebral blood flow in cm/s1).

We hypothesize that the decreased cardiac output in patients with severe aortic valve stenosis leads to reduced cerebral blood flow in a subset of patients which may be restored by TAVI.

Measurements will be performed at two points in time: 1) Baseline (prior to TAVI), 2) 3 months after TAVI

TAVI