You're Never Too Old

The Clinical Problem-Solving article “Too Old for What?” elsewhere in this issue1 describes an 87-year-old woman with severe aortic stenosis, three-vessel coronary artery disease, depressed left ventricular function, and moderately severe heart failure. Once the diagnosis of aortic stenosis was made, neither the patient's physicians nor the discussant considered nonsurgical therapy, but in an accompanying note the editor wonders whether the discussion, which strongly favors surgery, might be too one-sided. Might the risks of surgery outweigh the expected benefit of symptomatic improvement? Should the possibility of improved life expectancy have a role in such decisions? How should the potential for . . .