Clinical-functional assessment of patients with aortic stenosis undergoing transcatheter aortic valve implantation

Abstract

Background: transcatheter aortic valve implantation (TAVI) is known to enhance valve structure and function in old adults with aortic stenosis. Aim: to evaluate the clinical and functional characteristics of 40 patients (mean age 79 ± 5 years) undergoing transfemoral TAVI during their hospital stay. Methods: this cross-sectional study. Data on mean aortic valve area, Society of Thoracic Surgeons (STS) morbidity and mortality score, echocardiographic measurements, peak cough flow (PCF), handgrip strength (HGS), 5-meter walk test (5MWT), and 6-minute walk test (6MWT) were collected at three time points: pre-TAVI, post-TAVI, and at hospital discharge. Results: results showed reductions in peripheral oxygen saturation (p = 0.004), peak aortic gradient (p = 0.001), and mean aortic gradient post-TAVI (p = 0.001), along with increased left ventricular ejection fraction (p = 0.001) and prolonged 5MWT completion time on the first postoperative day (p =0.003). Moderate negative correlations were observed between the European System for Cardiac Operative Risk Evaluation II score (EuroSCORE II) score and PCF (r = -0.329; p = 0.041), STS with PCF (r = -0.473; p = 0.002), and STS with 6MWT at discharge (r = -0.324; p = 0.044), as well as STS with HGS pre-TAVI (r = -0.363; p = 0.041). Conclusion: changes in clinical and functional variables, the increase in 5MWT time suggests a deterioration in frailty in the population. Implementing pre- and postoperative rehabilitation programs may help mitigate functional losses in this clinically vulnerable population.