TAVR in older adults with cardiogenic shock:current prac-tice and future direction
Min Ji Kwak1
Jorge A.Irizarry-Caro2
Paola Rodriguez Martinez2
James Going2
Jessica Lee1
Dana Giza1
Nuzah Amjad1
Ana Leech1
Rachel Jantea1
Renee Flores1
Nahid Rianon1
Abhijeet Dhoble3
1.Division of Geriatric and Palliative Medicine,McGovern Medical School,TX,USA;Department of Internal Medi-cine,McGovern Medical School,TX,USA2.Department of Internal Medi-cine,McGovern Medical School,TX,USA3.Department of Internal Medi-cine,McGovern Medical School,TX,USA;Division of Cardiovascular Medicine,McGovern Medical School,TX,USA
摘要：Aortic stenosis(AS)is one of the most common types of valvular heart disease in older adults,with age being significantly associated with the development of AS.The transcatheter aortic valve replacement(TAVR)procedure,since it was first performed in 2002,has emerged as a preferred treatment option for patients who are at intermediate to high surgical risk due to advanced age or medical comorbidities.Older adults with severe AS may present with acute decompensated heart failure lead-ing to cardiogenic shock(CS).Among patients 65 years and older with AS presenting for TAVR,4.1％were reportedly in acute CS.Regardless of etiology,mortality from CS itself is high(30％-50％)and increases with advancing age.TAVR for these patients could provide a definite treatment for both AS and CS.There is still limited evidence regarding the safety and efficacy of TAVR in this population,but recent studies are promising,with successful procedural results and a good recovery rate after the procedure.However,particularly for older adults,there are other factors that clinicians should consider during pre-and post-procedural status,such as patient's goals,frailty,polypharmacy,dementia,or delirium.In this article,we reviewed current studies regard-ing TAVR for older adults with AS and CS,the reason for comprehensive geriatric assessment,and the introduction of appropri-ate geriatric assessment tools based on the Age-Friendly 4Ms framework that cardiologists can adopt in real-world practice.
机标关键词：currentfuturetavrwithadultscardiogenicdirectionolder
论文发表日期：2025-05-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 525-533 )