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When it comes to valve procedures, "success" looks different depending on who you ask. A presentation at TCT 2026 highlighted that frailty assessments should go beyond clinical metrics to incorporate patient goals—like simply being able to walk to the mailbox. Structured tools and shared decision-making can help heart teams align treatment plans with what patients actually value.
Heart teams evaluating patients for aortic, mitral, or tricuspid valve procedures often define "success" by clinical outcomes—procedure completion, no major complications, discharge home. But patients may have a very different definition. At TCT 2026, Misty Theriot, RN, urged heart teams to incorporate patient-centered goals into frailty assessments, noting that a patient's aim might be as modest as walking to the mailbox or breathing more easily at home.
Frailty, distinct from exercise capacity or physical function tests, reflects a patient's physiological reserve—essentially how much "battery life" they have to undergo and recover from a procedure. Tools like the Clinical Frailty Scale, Fried phenotype, and the Essential Frailty Toolset can quantify frailty across physical, cognitive, and social domains, offering insights that a chart review alone can't provide. Theriot emphasized that advanced practice clinicians and nurses play a key role in conducting and communicating these assessments to the broader heart team.
Key Takeaways:
Why it matters: Aligning procedural decisions with patient goals isn't just good ethics—it's good medicine. As valve interventions expand to older, frailer populations, structured frailty assessments and validated decision aids can help ensure patients receive care that matches what they actually value.
