Patients who undergo transcatheter aortic valve replacement often are
frail and elderly. Delirium is a frequently observed complication,
associated with impaired recovery, prolonged hospital stay, and
mortality. In different hospital settings, interventions that reduced
the incidence of delirium resulted in improved clinical outcome and
reduced costs. In that context, prevention, early recognition, and
timely interventions could be the next step toward better outcomes of
transcatheter aortic valve replacement. This review is focused on
awareness and recognition of delirium, including predisposing
“vulnerability” factors (such as cognitive impairment and carotid artery
disease) and “trigger” factors (such as anesthesia, hemodynamic
imbalance, and complications). For prevention and treatment, clinicians
should focus on sleep hygiene, orientation, pain management, and early
mobilization. In case of delirium, a thorough search and treatment of
trigger factors is warranted. Future studies should focus on risk
assessment, preventive and therapeutic interventions, and their
potential benefit in terms of costs and clinical outcomes.
