Key result
Advances in surgical and catheter-based technologies offer definitive treatment for older adults with severe valvular heart disease, though comorbidities and frailty complicate patient selection.
This review highlights the evolving surgical and catheter-based treatments for severe valvular heart disease in older adults, emphasizing the importance of patient selection, frailty assessment, and quality of life goals.
Valvular heart disease is associated with aging and the incidence is increasing as the population ages. Aortic stenosis and mitral regurgitation represent the majority of valvular disease in older adults. Severe valvular disease is associated with the development of heart failure, arrhythmia and death. Unfortunately, medical therapy is ineffective for the treatment of severe symptomatic valvular disease. As a result of advances in surgical techniques and catheter-based technologies, older adults who were once deemed ‘too old/sick’ are now being offered definitive treatment. However, the presence of comorbidities and frailty in the elderly make patient selection difficult and prediction of overall response to therapy less reliable compared with younger patients. In the elderly, goals of therapy may differ, with an emphasis placed on quality of life, functionality, maintaining independence and palliation of severe symptoms rather than increased longevity. We review the epidemiology and treatment approaches for valvular heart disease in older adults.
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Green et al. (2013) conducted a review in Valvular heart disease. Surgical techniques and catheter-based technologies was evaluated. Advances in surgical and catheter-based technologies offer definitive treatment for older adults with severe valvular heart disease, though comorbidities and frailty complicate patient selection.
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