title: [Aortic valve replacement and screening for frailty].
abstract: The prevalence of aortic stenosis is increasing due to aging of the general population. Transcatheter aortic valve implantation (TAVI) is an alternative for surgical aortic valve replacement (AVR) for high-risk patients. Cardiac scoring systems have been developed to predict the risk of adverse outcomes following surgery, but currently they do not include frailty parameters, and frail patients have an increased risk of adverse health outcomes. Preoperative frailty correlates with adverse outcomes, mortality and functional decline in patients undergoing TAVI; by identifying these patients it is possible to counteract symptoms of frailty by implementing tailored intervention by the geriatrician. The Comprehensive Geriatric Assessment (CGA) is a tool used to detect frailty. Based on the current literature, we highly recommend performing a CGA and a minimum of a Timed Up and Go test, a mini nutritional assessment and serum albumin measurements in patients aged > 70 years undergoing a TAVI or surgical AVR, in order to aim reducing the accompanying risks of the intervention.
authors.affiliation: Slotervaartziekenhuis, Amsterdam.
authors.forename: Floor
authors.initials: F
authors.lastname: van den Hanenberg
authors.forename: Gideon
authors.initials: G
authors.lastname: Mairuhu
authors.forename: C J Kees
authors.initials: CJ
authors.lastname: Kalisvaart
authors.forename: Jan
authors.initials: J
authors.lastname: Baan
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Maier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome