Does aortic valve replacement benefit frail patients?

Study suggests carrying out a frailty assessment in patients before the procedure

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:

  1. Excellent: from excellent at baseline to improvement at follow-up seen in 24.1% of patients
  2. Good: high baseline to full recovery seen in 29.9% of patients 
  3. Fair: moderate baseline to minimal decline seen in 30.7% of patients
  4. Poor: low baseline to moderate decline seen