Key result
TAVI in nonagenarians is linked to a ~13% perioperative decline in gait speed.
Observational (n=38)
No
Absolute Event Rate: 0.7% vs 0.8%
p-value: p=0.001
In carefully selected nonagenarians, TAVI does not substantially worsen most frailty indices, though mild in-hospital declines in gait speed and ADL highlight the need for early structured rehabilitation.
Mild gait speed decline after TAVI in nonagenarians may warrant rehab focus; leaves open whether frailty remains stable in unselected patients.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis (AS) in older patients, including nonagenarians. This study aimed to examine perioperative changes in frailty among nonagenarian patients undergoing TAVI. METHODS AND RESULTS: In this single-center observational analysis, 38 consecutive nonagenarian patients (7.3% of 523 TAVI cases) were evaluated. Frailty parameters-including grip strength, cognitive function (MMSE), overall physical performance (SPPB), gait speed, and activities of daily living (Katz index)-were measured before and after the procedure. No significant differences were observed between preoperative and postoperative values for grip strength (17.4 ± 7.1 vs. 16.1 ± 7.4 kgf, p = 0.102), MMSE (24.1 ± 3.9 vs. 24.3 ± 4.6, p = 0.923), or overall SPPB scores (8.7 ± 2.8 vs. 7.5 ± 3.0, p = 0.084). In contrast, gait speed decreased significantly from 0.8 ± 0.3 m/s to 0.7 ± 0.3 m/s (p = 0.001), and the Katz index also showed a small but statistically significant decline (p = 0.042). The proportion of patients with a walking speed below 0.9 m/s did not change significantly (67.6% vs. 83.8%, p = 0.146). CONCLUSIONS: In a carefully selected nonagenarian cohort, TAVI did not substantially worsen most frailty indices. However, mild in-hospital declines in gait speed and ADL were observed, underscoring the importance of structured early rehabilitation strategies.
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Kobayashi et al. (2026) conducted an observational in Severe aortic stenosis (n=38). Transcatheter aortic valve implantation (TAVI) vs. Preoperative baseline was evaluated on Gait speed (m/s) (p=0.001). In nonagenarians undergoing transcatheter aortic valve implantation, most frailty indices remained stable, but gait speed significantly decreased from 0.8 m/s to 0.7 m/s during the perioperative period.
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