Told I am too frail for open heart surgery but they are still assessing me for TAVR. What is the frailty test and can I fail it?

#1WalterP(Joined Sep 2026 · 4 posts)September 22, 2026, 10:40 am

83, severe aortic stenosis diagnosed in June, and a lot of breathlessness since about Easter. The surgeon I saw first was very straightforward and said open surgery was "not a good idea at your age and with your chest", I have COPD from forty years of pipe smoking which I have given up now, too late I know.

Then I was sent to the TAVR people and they have booked me for what the letter calls a "frailty assessment" with a nurse and a physiotherapist. Walking test, grip test, questions about whether I can do my own shopping, memory questions. I was a sergeant in the army and the idea of being tested on whether I am feeble does not sit well, I will be honest.

What I want to know is whether you can fail this and be sent home with nothing. If I am too frail for surgery and too frail for TAVR, what then?

#2TwoNightsTerry(Joined Feb 2026 · 63 posts)September 22, 2026, 3:55 pm

Walter, I had a version of that too, at 75. Walk up and down a corridor while she timed me, get up out of a chair five times without using my arms, squeeze a gadget. It felt daft at the time. I asked her afterwards what it was for and she said it was so they could tell the difference between someone who is old and someone who is worn out, because those are not the same thing.

#3Marlene K(Joined Mar 2026 · 31 posts)September 23, 2026, 9:20 am

The memory questions were the bit I hated. Name three things, remember them, they ask again later. I forgot the third one out of pure nerves and spent the whole bus ride home convinced I had ruined everything. I had not.

#4Diane FarrowFounder(Joined Jan 2026 · 214 posts)September 24, 2026, 6:30 pm

WalterP said:

whether you can fail this and be sent home with nothing

Walter, I understand the sergeant's reaction completely, but the assessment is not a pass or fail exam. From everything I have learned and from my own heart team, it is one of the inputs the multidisciplinary team uses to judge whether a valve procedure is likely to give you a better life, not a test of character. Age on its own does not decide that. Terry's nurse put it well: they are trying to tell apart someone who is old and someone who is worn out by other illnesses, and the answer helps them plan the procedure and the recovery as much as decide on it.

I am not a doctor and I cannot tell you what your team will conclude. What I can say is that being judged too risky for open surgery is one of the most common reasons people are offered TAVR in the first place, and the site's guide to am I a candidate for TAVR sets out how the team weighs age, surgical risk, anatomy on CT, and conditions like your COPD. Breathlessness from a failing valve can also make people look frailer than they are, which the team knows well.

If the team does decide against a valve procedure, you would not be sent home with nothing. There are still medicines for symptoms, support from heart failure and palliative care teams, and sometimes other procedures. Ask them directly, at the assessment, what happens in each case. And bring someone with you, if you can. A second pair of ears is worth a great deal at these appointments.

#5WalterP(Joined Sep 2026 · 4 posts)September 30, 2026, 8:15 pm

Did the tests yesterday. Got up out of the chair five times, slower than I would like, walked the corridor with a stop halfway, which the physio said was "about what we expected with your valve". Memory questions all correct, thank you very much Marlene.

She said the results go to the team meeting next week. Felt less like an exam than I had feared. My daughter came with me and wrote everything down.

#6WalterP(Joined Sep 2026 · 4 posts)October 7, 2026, 12:05 pm

Heart team meeting happened. They are going ahead with TAVR through the groin, date in November. The cardiologist said the frailty tests and my lung tests were the main reasons they want me home quickly and in rehab soon after, rather than any reason to refuse. So, not failed. Will report back.