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Transcatheter Aortic Valve Replacement Patient Selection: A Frailty-Centered Approach

Samer Ellahham, Hanan Sheikh Ibrahim, Mariam Hassan

Aortic stenosis (AS) is, single-handedly, a significant cause of morbidity and mortality among the elderly. An indubitable appreciation has mounted for transcatheter aortic valve replacement (TAVR) in scenarios that mandate rectifying stenotic aortic valves. This procedure is a sensible alternative to surgical replacement in severely symptomatic or high-risk patients. Furthermore, the elderly population is innately liable to cultivating a variety of seemingly innocuous risk factors, termed frailty syndromes. Although proven to be a predictor of poor post-TAVR outcomes, frailty is more often than not omitted from preprocedural screening. It is only fair that repair strategies are extensively discussed between cardiologists and geriatricians, alike. As such, the current review aims to highlight the role of frailty in patient selection for TAVR, prognostication, and tailoring post-operative care to enhance quality of life. Further research in this area will empower cardiologists to better assign management plans for TAVR patients by employing frailty, and so reducing overall cardiovascular risk.