Key result
Transcatheter aortic valvular replacement improves survival and quality of life in non-operable elderly patients with symptomatic severe aortic stenosis compared to regular medical management.
This review summarizes the pathophysiology, diagnosis, and management of aortic stenosis in elderly patients, emphasizing the role of TAVR in non-operable symptomatic cases.
Elderly patients experiencing valvular aortic stenosis (AS) show an increased prevalence of coronary risk factors, coronary artery disease, and other atherosclerotic vascular diseases. Angina pectoris, syncope or near syncope, and congestive heart failure are the 3 classic manifestations of severe AS in patients. Prolonged duration and late peaking of an aortic systolic ejection murmur best differentiate severe AS from mild AS upon physical examination of the patient. Doppler echocardiography is used to diagnose the severity of patient AS. In the article, indications for aortic valve replacement (AVR) in patients, the use of warfarin after AVR in patients with mechanical prostheses, and the use of aspirin or warfarin after AVR in patients with bioprosthesis are discussed. Transcatheter aortic valvular replacement should be performed in non-operable patients with symptomatic severe AS to improve their survival and quality of life rather than using regular medical management of the condition.
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Wilbert S. Aronow (2013) conducted a review in Aortic Valve Stenosis. Aortic valve replacement and transcatheter aortic valvular replacement vs. Regular medical management was evaluated. Transcatheter aortic valvular replacement improves survival and quality of life in non-operable elderly patients with symptomatic severe aortic stenosis compared to regular medical management.
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