Frailty in patients undergoing transcatheter aortic valve replacement:from risk scores to frailty-based management
摘要Aortic stenosis (AS) is the most common valvular disease in the western coun-tries and is associated with aging.[12]Transcatheter aortic valve replacement (TAVR) now offers a therapeutic option for elderly patients who are deemed inoperable and is an excellent alternative for those who are considered high-risk for surgical valve replacement.[3,4] However,mortality after TAVR is still high with one-year and two-year mortality rates of 24.3% and 33.9%,respectively.[5] Thus,util-ization of effective risk stratification tools before TAVR cannot be overstated.[5-8] Currently,EUROSCORE Ⅱand the Society of Thoracic Surgery score are the re-commended risk models to predict postoperative mortality in cardiac surgery,however,they were not designed to be used for TAVR patients.[6,8] The main limitation in the implementation of these models is that they do not take into account frailty.[9]Frailty assessment could not only offer incremental prognostic information but could also theoretically improve outcomes with preoperative or postoperative management and modification of specific frailty components.[10,11]
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