{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T12:11:03Z","timestamp":1777551063047,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2017,6,26]],"date-time":"2017-06-26T00:00:00Z","timestamp":1498435200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neurologic complications and neurocognitive impairment due to cerebral emboli are common following heart surgery. This study aimed to compare the number of emboli detected in the middle cerebral artery in open aortic valve replacement, apical and femoral transcatheter aortic valve replacement, and also to test for an association between the number of emboli captured in each procedure and changes in the patient\u2019s cognitive state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty-four patients were enrolled in the study, 36 of whom were included in the final analyses: 14 underwent open aortic valve replacement, 2 had femoral transcatheter aortic valve replacement, and 10 had apical transcatheter aortic valve replacement. The number of emboli was detected by middle cerebral artery intraoperative transcranial Doppler ultrasound. The day before the elective surgery and 6\u201312 weeks later, all patients underwent neurocognitive evaluations by the Mini-Mental State Examination; the difference was tested for an association with the number of emboli.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Open aortic valve replacement resulted in a significantly greater number of emboli (8555, range 2999\u201312489) than apical (1962, range 521\u20133850) or femoral (1220, range 948\u20131946) transcatheter approaches ( p\u2009=\u20090.003). Both transcatheter approaches yielded a comparable amount of emboli ( p\u2009=\u20090.798). No significant association was observed between the change in Mini-Mental State Examination score and the mean number of emboli ( r\u2009=\u20090.026; p\u2009=\u20090.907).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared to transcatheter aortic valve replacement, more cerebral emboli are detected during surgical aortic valve replacement; however, this does not appear to adversely affect a patient\u2019s cognitive state.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0218492317717794","type":"journal-article","created":{"date-parts":[[2017,6,26]],"date-time":"2017-06-26T04:12:06Z","timestamp":1498450326000},"page":"425-431","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Emboli and cognitive state in surgical vs. transcatheter aortic valve replacement"],"prefix":"10.1177","volume":"25","author":[{"given":"Tom","family":"Friedman","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oved","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avishai","family":"Ziser","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Kerner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Bitton-Worms","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gil","family":"Bolotin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, 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