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Recovery Timeline After TAVI — EECC MCQ

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EasyValvular Heart DiseaseRecovery Timeline After TAVIEECC

A 75-year-old woman with symptomatic severe AS undergoes successful TAVI. Post-procedure echocardiography shows a mean gradient of 8 mmHg and no paravalvular regurgitation. At 3-month follow-up, she reports significant improvement in dyspnoea but persistent fatigue. Her LVEF has improved from 45% to 55%. What is the expected timeline for full symptomatic recovery after TAVI?

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Correct answer: D — Full functional recovery after TAVI is gradual over 3-6 months; cardiac rehabilitation accelerates recovery — persistent fatigue at 3 months may reflect deconditioning, anaemia, or comorbidities rather than prosthesis dysfunction

After TAVI for severe AS, haemodynamic improvement is immediate (relief of outflow obstruction), but functional recovery is gradual: (1) dyspnoea typically improves within weeks (reduced LV afterload, improved diastolic function); (2) exercise capacity improves over 3-6 months (LV mass regression, muscle reconditioning); (3) full benefit may take 6-12 months (particularly if there is pre-existing deconditioning, pulmonary disease, or frailty). Cardiac rehabilitation post-TAVI is recommended and accelerates functional recovery. Persistent fatigue at 3 months should prompt assessment of: (1) prosthesis function (echo — low gradient, no PVR = good); (2) anaemia; (3) thyroid dysfunction; (4) deconditioning (rehabilitation referral); (5) depression; (6) concomitant CAD. LVEF improvement from 45% to 55% is an excellent response.

Reference: ESC/EACTS (2025): VHD Guidelines