A Comprehensive Geriatric Workup and Frailty Assessment in Older Patients with Severe Aortic Stenosis.
Enrico BrunettiGiovanni De LucaRoberto PrestaNiccolò MarchionniAlessandro BoccanelliAndrea UngarCarmelo Massimiliano RaoNadia IngianniMaddalena LettinoDonatella Del SindacoAdriano MurroneCarmine RiccioFurio ColivicchiMassimo GrimaldiMichele Massimo GuliziaFabrizio OlivaMario BoIris Parrininull nullPublished in: Journal of clinical medicine (2024)
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.
Keyphrases
- aortic stenosis
- transcatheter aortic valve replacement
- community dwelling
- aortic valve
- aortic valve replacement
- transcatheter aortic valve implantation
- ejection fraction
- hip fracture
- left ventricular
- middle aged
- decision making
- coronary artery disease
- multiple sclerosis
- quality improvement
- mental health
- heart failure
- human health
- metabolic syndrome
- risk assessment
- mitral valve
- weight loss
- genetic diversity
- skeletal muscle