Six-month functional outcomes in elderly patients with severe aortic stenosis: percutaneous versus surgical

Jesús A. Gómez-García, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico
María J. Bojórquez-Lopez, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico
Itzel Reyes-Salcedo, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico
Manuel A. Bustillos-Cuevas, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico

Background: Severe aortic stenosis (SAS) is a common valvular disease in older adults, with a prevalence of 9.8% in those aged 80-89 years. Surgical aortic valve replacement (SAVR) is the standard treatment, whereas transcatheter aortic valve implantation (TAVI) has emerged as a less invasive alternative. Functional assessment is crucial for this population. Objective: The objective of the study was to compare functional outcomes in elderly patients with symptomatic SAS undergoing TAVI versus SAVR after 6 months. Material and methods: A retrospective cohort study including patients aged ≥70 years with SAS treated with TAVI or SAVR between September 2023 and 2024. Functional status was assessed using the Barthel index (BI) at baseline and 6 months. Data were analyzed using descriptive and inferential statistics (Student’s t-test) using the Statistical Package for Social the Sciences v25 and Excel. Results: A total of 155 patients were analyzed (TAVI, n = 47; SAVR, n = 108). The TAVI group was older (80 ± 6 vs. 76 ± 4 years, p < 0.05) and had more comorbidities (3 vs. 2) and geriatric syndromes (6 vs. 4) than the surgical group. The baseline BI was similar (89, p = 0.232). After 6 months, functionality remained stable (BI = 90, p = 0.525), with no significant difference in BI change (TAVI −0.53 vs. SAVR + 0.47). Conclusion: Functional status remained stable and comparable between TAVI and SAVR, suggesting similar effectiveness despite higher vulnerability in TAVI patients.

Keywords: Treatment outcomes. Transcatheter aortic valve replacement. Aortic valve stenosis. Observational study.