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Background <p>Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis (AS) in older patients, including nonagenarians. This study aimed to examine perioperative changes in frailty among nonagenarian patients undergoing TAVI.</p> Methods and results <p>In this single-center observational analysis, 38 consecutive nonagenarian patients (7.3% of 523 TAVI cases) were evaluated. Frailty parameters—including grip strength, cognitive function (MMSE), overall physical performance (SPPB), gait speed, and activities of daily living (Katz index)—were measured before and after the procedure. No significant differences were observed between preoperative and postoperative values for grip strength (17.4 ± 7.1 vs. 16.1 ± 7.4 kgf, <i>p</i> = 0.102), MMSE (24.1 ± 3.9 vs. 24.3 ± 4.6, <i>p</i> = 0.923), or overall SPPB scores (8.7 ± 2.8 vs. 7.5 ± 3.0, <i>p</i> = 0.084). In contrast, gait speed decreased significantly from 0.8 ± 0.3&#xa0;m/s to 0.7 ± 0.3&#xa0;m/s (<i>p</i> = 0.001), and the Katz index also showed a small but statistically significant decline (<i>p</i> = 0.042). The proportion of patients with a walking speed below 0.9&#xa0;m/s did not change significantly (67.6% vs. 83.8%, <i>p</i> = 0.146).</p> Conclusions <p>In a carefully selected nonagenarian cohort, TAVI did not substantially worsen most frailty indices. However, mild in-hospital declines in gait speed and ADL were observed, underscoring the importance of structured early rehabilitation strategies.</p>

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Perioperative frailty in nonagenarians undergoing transcatheter aortic valve implantation: a single-center study

  • 期刊论文

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  • 发表日期：

    2026年2月5日

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  • Kiyonori Kobayashi,
  • Yoshiyuki Tokuda,
  • Akihito Tanaka,
  • Takahiro Ozeki,
  • Toyoaki Murohara,
  • Masato Mutsuga

摘要

Background

Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis (AS) in older patients, including nonagenarians. This study aimed to examine perioperative changes in frailty among nonagenarian patients undergoing TAVI.

Methods and results

In this single-center observational analysis, 38 consecutive nonagenarian patients (7.3% of 523 TAVI cases) were evaluated. Frailty parameters—including grip strength, cognitive function (MMSE), overall physical performance (SPPB), gait speed, and activities of daily living (Katz index)—were measured before and after the procedure. No significant differences were observed between preoperative and postoperative values for grip strength (17.4 ± 7.1 vs. 16.1 ± 7.4 kgf, p = 0.102), MMSE (24.1 ± 3.9 vs. 24.3 ± 4.6, p = 0.923), or overall SPPB scores (8.7 ± 2.8 vs. 7.5 ± 3.0, p = 0.084). In contrast, gait speed decreased significantly from 0.8 ± 0.3 m/s to 0.7 ± 0.3 m/s (p = 0.001), and the Katz index also showed a small but statistically significant decline (p = 0.042). The proportion of patients with a walking speed below 0.9 m/s did not change significantly (67.6% vs. 83.8%, p = 0.146).

Conclusions

In a carefully selected nonagenarian cohort, TAVI did not substantially worsen most frailty indices. However, mild in-hospital declines in gait speed and ADL were observed, underscoring the importance of structured early rehabilitation strategies.