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Gériatrie et Psychologie Neuropsychiatrie du Vieillissement

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Frailty, depression and prognosis after transcatheter aortic valve replacement: a review of the literature Volume 19, issue 1, Mars 2021

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Authors
1 Pôle de gérontologie, CHU Montpellier, Université de Montpellier, France
2 Département de cardiologie, CHU Montpellier, Université de Montpellier, France
* Correspondance

A systematic review of the literature was conducted to analyze the results of studies evaluating the link between frailty and depression before percutaneous aortic valve replacement (TAVR) and vital prognosis and quality of life after TAVR. The literature indicates that TAVR is a procedure that improves quality of life for one year in older subjects, the longer-term effect being debated, possibly depending on the underlying comorbidities and their own course. The presence of depression before and after TAVR is associated with a lower quality of life before and after TAVR, suggesting to screen it systematically before and after TAVR. The underlying frailty of elderly patients eligible for TAVR is associated with excess mortality, justifying assessing before TAVR functional and cognitive reserves, and nutritional status of patients, especially. The link between depression before TAVR and excess mortality after TAVR is not clearly demonstrated and may in part be linked to apathy or impaired executive functions which can mimic depression and which should also be investigated before TAVR.