Heart, Lung and Circulation

Impact of Surgical and Transcatheter Aortic Valve Replacement on Frailty Score

Published:October 13, 2021DOI:


      Frailty is common in the aortic stenosis (AS) population and impacts outcomes after both transcatheter and surgical aortic valve replacement (TAVR and sAVR, respectively). Frailty can significantly impact the decision regarding the suitability of a patient for aortic valve intervention, with frail patients often excluded. Since many frailty tools use indicators which may be influenced by AS itself, some of which are subjectively symptom driven, we sought to determine the impact of intervention on frailty scores.


      A prospective, observational cohort study included patients being assessed for aortic valve (AV) intervention with either TAVR or sAVR due to severe aortic stenosis. Patients were assessed for symptoms at baseline, and 1- and 6-months post intervention subjectively, using the New York Heart Association (NYHA) class and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and objectively, using a 6-minute walk test (6MWT). These were compared with frailty at baseline and final review using the Fried Frailty Scale (FFS).

      Results and Conclusions

      Sixty-six (66) patients completed pre- and post-intervention reviews. The mean FFS score was significantly lower, indicating less frailty, at 6 months relative to pre procedure (1.18 vs 1.73, p=0.002). This correlated with the change in symptoms (p<0.001). Between intervention groups, the final mean FFS of both groups decreased significantly, with TAVR to 1.33 (p=0.030) and sAVR to 0.8 (p=0.015). There was no difference in the degree of improvement between interventions (p=0.517). Aortic valve intervention improves frailty scores in both TAVR and sAVR treated patients.


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      Linked Article

      • Frailty as a Dynamic Measure for the Assessment of Aortic Valve Intervention
        Heart, Lung and CirculationVol. 31Issue 4
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          The candidacy of patients for major cardiac interventions is based on assessment of their co-morbidities and physical status. As the population ages, older patients with significant medical problems present with potentially correctable cardiovascular conditions. The “Heart Team” approach with multidisciplinary discussions has become the standard of care in most institutions to identify patients who are suitable for intervention and are reflected in recent guidelines [1]. The members of a “Heart Team” vary between institutions, but there is an increasing involvement of geriatricians reflecting the ageing population.
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