Questions have been raised over the value of aortic valve replacement in elderly patients with severe frailty in the wake of a study that shows they often experience functional decline or lack of improvement afterwards.

The Israeli-led researchers conducted telephone interviews with 246 older patients (mean age of 78.1) to assess self-reported ability to perform activities and physical tasks in the year after they had undergone either a transcatheter (TAVR) or surgical (SAVR) aortic valve replacement.

They identified five functional trajectories:

Mortality at 12 months increased with worsening functional trajectory, from 3.5% of patients with excellent functional outcomes to 2.9% of those with good outcomes, 9.9% of those with fair outcomes, 25.0% of those with poor outcomes and 69.2% of those with very poor functional trajectories.