A comprehensive multidisciplinary geriatric evaluation, incorporating frailty and cognitive assessments, is recommended before TAVR to optimize decision-making and patient-centered outcomes in older adults.
Comprehensive geriatric assessment and frailty evaluation are crucial for risk stratification and decision-making in older patients undergoing TAVR for severe aortic stenosis.
Aortic stenosis (AS) represents a notable paradigm for cardiovascular (CV) and geriatric disorders owing to comorbidity. Transcatheter aortic valve replacement (TAVR) was initially considered a therapeutic strategy in elderly individuals deemed unsuitable for or at high risk of surgical valve replacement. The progressive improvement in TAVR technology has led to the need to refine older patients' stratification, progressively incorporating the concept of frailty and other geriatric vulnerabilities. Recognizing the intricate nature of the aging process, reliance exclusively on chronological age for stratification resulted in an initial but inadequate tool to assess both CV and non-CV risks effectively. A comprehensive geriatric evaluation should be performed before TAVR procedures, taking into account both physical and cognitive capabilities and post-procedural outcomes through a multidisciplinary framework. This review adopts a multidisciplinary perspective to delve into the diagnosis and holistic management of AS in elderly populations in order to facilitate decision-making, thereby optimizing outcomes centered around patient well-being.
Brunetti et al. (Tue,) conducted a review in Severe Aortic Stenosis. Comprehensive geriatric evaluation and frailty assessment was evaluated. A comprehensive multidisciplinary geriatric evaluation, incorporating frailty and cognitive assessments, is recommended before TAVR to optimize decision-making and patient-centered outcomes in older adults.
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