Preoperative Cognitive Impairment Predicts Short-Term Mortality After Aortic Arch Replacement: A Prospective Cohort Study
Presented During:
Monday, May 4, 2026: 9:00AM - 4:00PM
McCormick Place Lakeside Center
Posted Room Name:
Exhibit Hall, Poster Area
Abstract No:
P0149
Submission Type:
Abstract Submission
Authors:
Xuyang Chen (1), Xiaogang Sun (2)
Institutions:
(1) N/A, Beijing, Beijing, (2) Fuwai Hospital, Beijing, Xicheng Distric
Submitting Author:
Xuyang Chen
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Co-Author:
Xiaogang Sun
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Fuwai Hospital
Fuwai Hospital
Abstract:
Objective: Patients undergoing aortic arch replacement are at high risk for neurological complications. While cerebral protection strategies are well established, the impact of preoperative cognitive function remains understudied. This study examined whether cognitive impairment assessed by the Montreal Cognitive Assessment (MoCA) predicts short-term outcomes after aortic arch surgery.
Methods: In this prospective cohort study, 104 patients who underwent aortic arch replacement between September 2023 and March 2025 were enrolled. Preoperative cognition was evaluated using the MoCA, with score <18 defined as moderate to severe cognitive impairment (MSCI). The primary outcome was all-cause mortality during follow-up. Secondary outcomes included prolonged mechanical ventilation (>24 hours) and major perioperative complications. Multivariable logistic and Cox regression models were used, adjusting for confounders.
Results: Seventeen patients (16.3%) had MSCI. They were older and had poorer performance across all cognitive domains. MSCI was independently associated with prolonged ventilation (OR = 34.749; 95% CI: 1.645–734.221; p = 0.023) and higher follow-up mortality (HR = 12.530; CI: 1.786 – 87.922; p = 0.011). Kaplan–Meier analysis demonstrated significantly reduced survival in the MSCI group (log-rank p = 0.011), with survival differences emerging early and persisting over follow-up.
Conclusions: Preoperative MSCI is an independent predictor of short-term mortality and delayed recovery following aortic arch surgery. Routine MoCA screening may improve risk stratification and support individualized perioperative care.
Methods: In this prospective cohort study, 104 patients who underwent aortic arch replacement between September 2023 and March 2025 were enrolled. Preoperative cognition was evaluated using the MoCA, with score <18 defined as moderate to severe cognitive impairment (MSCI). The primary outcome was all-cause mortality during follow-up. Secondary outcomes included prolonged mechanical ventilation (>24 hours) and major perioperative complications. Multivariable logistic and Cox regression models were used, adjusting for confounders.
Results: Seventeen patients (16.3%) had MSCI. They were older and had poorer performance across all cognitive domains. MSCI was independently associated with prolonged ventilation (OR = 34.749; 95% CI: 1.645–734.221; p = 0.023) and higher follow-up mortality (HR = 12.530; CI: 1.786 – 87.922; p = 0.011). Kaplan–Meier analysis demonstrated significantly reduced survival in the MSCI group (log-rank p = 0.011), with survival differences emerging early and persisting over follow-up.
Conclusions: Preoperative MSCI is an independent predictor of short-term mortality and delayed recovery following aortic arch surgery. Routine MoCA screening may improve risk stratification and support individualized perioperative care.
ADULT CARDIAC:
Aorta and Great Vessels
Image or Table
