P149. Preoperative Cognitive Impairment Predicts Short-Term Mortality After Aortic Arch Replacement: A Prospective Cohort Study
Presented During: Adult Cardiac Poster Session II
Beijing, Beijing
China - Contact Me
MD/PhD Candidate in Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College
Monday, May 4, 2026: 9:00 AM - 4:00 PM
McCormick Place Lakeside Center
Room: Exhibit Hall, Poster Area
Description
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.
Authors
Xuyang Chen (1), Xiaogang Sun (2)
Institutions
(1) N/A, Beijing, Beijing, (2) Fuwai Hospital, Beijing, Xicheng Distric
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.
Authors
Xuyang Chen (1), Xiaogang Sun (2)
Institutions
(1) N/A, Beijing, Beijing, (2) Fuwai Hospital, Beijing, Xicheng Distric
Presentation Duration
There is no formal presentation for posters. Your poster will be on display on your assigned day from 9:00AM - 4:00PM
View Submission
ADULT CARDIAC
Aorta and Great Vessels