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Article

Surgical versus Transvalvular Aortic Valve Replacement in Elderly Patients—The Impact of Frailty

1
Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
2
Department of Internal Medicine, Sf Spiridon University Hospital, 700111 Iasi, Romania
3
Institute of Forensic Medicine, 700455 Iasi, Romania
4
Cardiovascular Diseases Institute, 700503 Iasi, Romania
5
Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, 700661 Iasi, Romania
*
Author to whom correspondence should be addressed.
Academic Editor: Michael Henein
Diagnostics 2021, 11(10), 1861; https://doi.org/10.3390/diagnostics11101861
Received: 30 August 2021 / Revised: 4 October 2021 / Accepted: 7 October 2021 / Published: 10 October 2021
(This article belongs to the Section Pathology and Molecular Diagnostics)
(1) Background: The aging process leads to an increased number of patients with cardiovascular diseases that require surgical treatment. One of the most common heart diseases with an increased prevalence in the elderly is aortic stenosis (AS). Recently, transcatheter aortic valve implantation (TAVI) has become the preferred technique for frail patients with high surgical risk. Currently, there is no gold standard method for assessing frailty. The available scores are objective, but limited by the lack of prospective information, especially from patients undergoing cardiac surgery or interventional procedures. Moreover, the current frailty scores record only certain aspects of the frailty identified in some system and organs. The aims of this study were to evaluate the different profile patients treated with TAVI or with surgical aortic valve replacement (SAVR) and to analyze the risk factors of unfavorable outcomes in the two groups to identify potential factors for frailty that could be included in the new scoring system. (2) Methods: This study included patients over 65 years old evaluated with severe, symptomatic AS treated with TAVI or SAVR admitted to the Cardiovascular Diseases Institute, Iasi. (3) Results: The group included 88 patients treated with TAVI compared with 218 patients undergoing SAVR. Most of the TAVI patients (84.09%) were over 70 years compared to 30.09% of the SAVR group. The TAVI patients had an increased surgical risk assessed by EuroSCORE II (15 vs. 4%) and severe heart failure (NYHA IV, 36.36 vs. 6.48%). The only residual symptom was dyspnea, in a significantly lower prevalence compared to preoperative evaluation. (4) Conclusions: TAVI improves the general status with results comparable to SAVR in elderly patients with increased severity of the disease and higher prevalence of comorbidities. View Full-Text
Keywords: aortic stenosis; frailty; transcatheter aortic implantation; surgical aortic valve replacement aortic stenosis; frailty; transcatheter aortic implantation; surgical aortic valve replacement
MDPI and ACS Style

Oancea, A.; Furnică, C.; Chistol, R.O.; Mitu, F.; Leon-Constantin, M.-M.; Tinică, G. Surgical versus Transvalvular Aortic Valve Replacement in Elderly Patients—The Impact of Frailty. Diagnostics 2021, 11, 1861. https://doi.org/10.3390/diagnostics11101861

AMA Style

Oancea A, Furnică C, Chistol RO, Mitu F, Leon-Constantin M-M, Tinică G. Surgical versus Transvalvular Aortic Valve Replacement in Elderly Patients—The Impact of Frailty. Diagnostics. 2021; 11(10):1861. https://doi.org/10.3390/diagnostics11101861

Chicago/Turabian Style

Oancea, Andra, Cristina Furnică, Raluca O. Chistol, Florin Mitu, Maria-Magdalena Leon-Constantin, and Grigore Tinică. 2021. "Surgical versus Transvalvular Aortic Valve Replacement in Elderly Patients—The Impact of Frailty" Diagnostics 11, no. 10: 1861. https://doi.org/10.3390/diagnostics11101861

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