A best evidence topic was devised in light of a structured protocol. What is the advantage of (minl"mally invasive) approach in (frail patients) undergoing (aortic valve replacement)? In cardiac outpatient cl...A best evidence topic was devised in light of a structured protocol. What is the advantage of (minl"mally invasive) approach in (frail patients) undergoing (aortic valve replacement)? In cardiac outpatient clinic you review an 85-year old male with severe aortic valve stenosis, low left ventricular ejection fraction and creatinine clearance of less than 50 mL/min. Other comorbidities include treated pulmonary hypertension, mild cognitive impairment, marked limitation of ordinary physical activity and depression. You resolve to determine whether to recommend mim'mally invasive or conventional aortic valve replacement (AVR) or transcathe- ter aortic valve implantation (TAVI), however you are not sure of the differences of the impact of frailty on preopera- tive risk for each approach; hence you investigate the best evidence on the topic.展开更多
文摘A best evidence topic was devised in light of a structured protocol. What is the advantage of (minl"mally invasive) approach in (frail patients) undergoing (aortic valve replacement)? In cardiac outpatient clinic you review an 85-year old male with severe aortic valve stenosis, low left ventricular ejection fraction and creatinine clearance of less than 50 mL/min. Other comorbidities include treated pulmonary hypertension, mild cognitive impairment, marked limitation of ordinary physical activity and depression. You resolve to determine whether to recommend mim'mally invasive or conventional aortic valve replacement (AVR) or transcathe- ter aortic valve implantation (TAVI), however you are not sure of the differences of the impact of frailty on preopera- tive risk for each approach; hence you investigate the best evidence on the topic.