Prehabilitation to Improve Functional and Clinical Outcomes in Patients With Aortic Stenosis

Prehabilitation to Improve Functional and Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement: TAVR-FRAILTY Trial

Transcatheter aortic valve replacement (TAVR) is a treatment alternative among high-risk elderly with aortic stenosis, however, mortality remains high. Fifty percent of patients undergoing TAVR exhibit frailty, a syndrome associated with poor survival. It is unknown whether interventions to improve frailty before TAVR (prehabilitation) will improve outcomes after TAVR. This study plans to evaluate whether simple cardiac exercise interventions to improve physical performance before TAVR improves outcomes after TAVR.

Inclusion criteria:

• Eligibility for TAVR
• SPPB<9
• Able to exercise
• Able to come for follow-up visits
• Able to give informed consent

Exclusion criteria:

• New York Heart Association (NYHA) Class III/IV congestive heart failure (CHF)
• Presyncope or syncope as presentation
• Acute coronary syndrome
• Unable to exercise
• Dementia
• Sustained ventricular arrhythmia
• Stroke with neurological deficit
• Advanced Parkinson's
• Participated in an exercise program