Quality of Life and Function After TAVI in Adults Aged ≥90 Years: Frailty and Multimorbidity Matter

INTRODUCTION: Previous reports of transcatheter aortic valve implantation (TAVI) in adults ≥90 years emphasise procedural success and survival. Whether nonagenarians experience clinically meaningful, sustained improvements in patient-reported outcomes, and how frailty and multimorbidity may modify these benefits, remains uncertain. METHODS: We performed an exploratory single-centre retrospective cohort study of consecutive nonagenarians undergoing TAVI (January 2019 - 31 October 2024). EuroQol 5-Dimensions 3-Level (EQ-5D-3L) (including Visual Analogue Scale, VAS) and the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) Summary Score were collected at baseline, 30 days and 12 months. Responders were defined using a ≥10-point minimally important difference. Deterioration was any negative pre- to 12-month change. Frailty was stratified into three prespecified Clinical Frailty Scale (CFS) categories: 1-3 (fit to managing well), 4-5 (vulnerable to mildly frail), and 6-9 (moderately to severely frail/terminally ill). RESULTS: Of 26 nonagenarians, 19 met inclusion criteria. Most were mildly-moderately frail (CFS 3-5: n=18; CFS 6: n=1). Median 30-day changes were +25 (IQR 10-38) for EQ-5D VAS (exact sign test p=0.001) and +39 (30-50) for KCCQ-12 (p