{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:02:03Z","timestamp":1792425723402,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,13]],"date-time":"2023-05-13T00:00:00Z","timestamp":1683936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Frailty is highly common in older patients (pts) undergoing transcatheter aortic valve replacement (TAVR), and it is associated with poor outcomes. The selection of patients who can benefit from this procedure is necessary and challenging. The aim of the present study is to evaluate outcomes in older severe aortic valve stenosis (AS) pts, selected by a multidisciplinary approach for surgical, clinical, and geriatric risk and referred to treatment, according to frailty levels. Methods: A total of 109 pts (83 \u00b1 5 years; females, 68%) with AS were classified by Fried\u2019s score in pre-frail, early frail, and frail and underwent surgical aortic valve replacement SAVR\/TAVR, balloon aortic valvuloplasty, or medical therapy. We evaluated geriatric, clinical, and surgical features and detected periprocedural complications. The outcome was all-cause mortality. Results: Increasing frailty was associated with the worst clinical, surgical, geriatric conditions. By using Kaplan\u2013Meier analysis, the survival rate was higher in pre-frail and TAVR groups (p &lt; 0.001) (median follow-up = 20 months). By using the Cox regression model, frailty (p = 0.004), heart failure (p = 0.007), EF% (p = 0.043), albumin (p = 0.018) were associated with all-cause mortality. Conclusions: According to tailored frailty management, elderly AS pts with early frailty levels seem to be the most suitable candidates for TAVR\/SAVR for positive outcomes because advanced frailty would make each treatment futile or palliative.<\/jats:p>","DOI":"10.3390\/jcdd10050212","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T08:31:36Z","timestamp":1684139496000},"page":"212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Positive Impact of Early Frailty Levels on Mortality in Elderly Patients with Severe Aortic Stenosis Undergoing Transcatheter\/Surgical Aortic Valve Replacement"],"prefix":"10.3390","volume":"10","author":[{"given":"Annamaria","family":"Mazzone","sequence":"first","affiliation":[{"name":"Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3722-8861","authenticated-orcid":false,"given":"Serena","family":"Del Turco","sequence":"additional","affiliation":[{"name":"CNR Institute of Clinical Physiology, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Trianni","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Quadrelli","sequence":"additional","affiliation":[{"name":"Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marotta","sequence":"additional","affiliation":[{"name":"Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bastiani","sequence":"additional","affiliation":[{"name":"CNR Institute of Clinical Physiology, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5181-7198","authenticated-orcid":false,"given":"Tommaso","family":"Gasbarri","sequence":"additional","affiliation":[{"name":"Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreina","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Mariani","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Basta","sequence":"additional","affiliation":[{"name":"CNR Institute of Clinical Physiology, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4604-0871","authenticated-orcid":false,"given":"Ilenia","family":"Foffa","sequence":"additional","affiliation":[{"name":"CNR Institute of Clinical Physiology, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7811-4265","authenticated-orcid":false,"given":"Silverio","family":"Sbrana","sequence":"additional","affiliation":[{"name":"CNR Institute of Clinical Physiology, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-6450","authenticated-orcid":false,"given":"Cristina","family":"Vassalle","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Ravani","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Solinas","sequence":"additional","affiliation":[{"name":"Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5244-0556","authenticated-orcid":false,"given":"Sergio","family":"Berti","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16006","DOI":"10.1038\/nrdp.2016.6","article-title":"Calcific aortic stenosis","volume":"2","author":"Lindman","year":"2016","journal-title":"Nat. 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