This review highlights that while surgical aortic valve replacement remains the standard for symptomatic severe aortic stenosis in the elderly, emerging transcatheter techniques offer new treatment avenues.
SAVR remains standard for symptomatic severe aortic stenosis; leaves open optimal selection for emerging transcatheter approaches pending prospective data.
Increased life-expectancy has led to a growing elderly population frequently presenting with aortic stenosis. This review focuses on the pathogenesis of calcific aortic stenosis, diagnosis and possible ways to halt the progression to severe symptomatic aortic stenosis, methods of assessing symptoms and severity, and modalities and timing of aortic valve replacement. At present the treatment of aortic stenosis for the majority of patients is surgical, and any patient with symptomatic severe aortic stenosis should be considered for aortic valve replacement. This article also discusses the role of emerging techniques of closed heart valve implantation either transfemoral or transapical, and which patients might be candidates for these new approaches to the treatment of aortic stenosis in the elderly population.
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Kappetein et al. (2008) studied this question.
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