Abstract：
Frailty is a common clinical syndrome that portends poor peri-procedural outcomes and increased mortality following transcatheter valve interventions. We reviewed frailty assessment tools in transcatheter intervention cohorts to recommend a pathway for preprocedural frailty assessment in patients referred for transcatheter valve procedures, and evaluated current evidence for frailty interventions and their efficacy in transcatheter intervention. We recommend the use of a frailty screening instrument to identify patients as frail, with subsequent referral for comprehensive geriatric assessment in these patients, to assist in selecting appropriate patients and then optimizing them for transcatheter valve interventions. Interventions to reduce preprocedural frailty are not well defined, however, data from limited cohort studies support exercise-based interventions to increase functional capacity and reduce frailty in parallel with preprocedural medical optimization.
摘要：
衰弱是一种常见的临床综合征，预示着经导管瓣膜介入术后不良的围手术期结局和死亡率增加。我们回顾了经导管介入队列中的虚弱评估工具，以推荐经导管瓣膜手术患者术前虚弱评估的途径。并评估了脆弱干预措施的现有证据及其在经导管干预中的疗效。我们建议使用虚弱筛查工具来识别虚弱的患者，随后对这些患者进行全面的老年评估，协助选择合适的患者，然后优化他们的经导管瓣膜介入治疗。减少程序前脆弱的干预措施没有明确定义，然而,来自有限队列研究的数据支持基于运动的干预措施,以增加功能容量和减少虚弱,同时进行术前医疗优化.
