Key result
Surgical and transcatheter aortic valve replacement are effective therapies for severe aortic stenosis in older adults, requiring a multidisciplinary approach for optimal management.
Optimal management of older adults with severe aortic stenosis requires a multidisciplinary approach considering comorbidities, frailty, and patient preferences when choosing between surgical and transcatheter valve replacement.
Supports multidisciplinary heart team evaluation for valve choice in older adults with severe AS; leaves open optimal selection criteria for prospective trials.
Calcific aortic stenosis (AS) is a condition that develops as a result of a chronic inflammatory process that leads to valve degeneration. Older adults exhibit an increased prevalence of aortic valvular fibrosis and calcification with associated sclerosis and stenosis. Severe AS requires relief of the obstruction to alleviate symptoms and reduce morbidity and mortality. Surgical aortic valve replacement is an effective therapy for severe AS and has been associated with excellent outcomes in selected octogenarians and nonagenarians. Transcatheter valve replacement is an effective alternative to surgery in patients who are inoperable or who pose a high surgical risk. Optimal management of older adults with severe AS requires a multidisciplinary approach with appropriate consideration of comorbid conditions, frailty and patient preferences.
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Shapiro et al. (2013) conducted a review in Aortic Stenosis. Surgical and transcatheter aortic valve replacement are effective therapies for severe aortic stenosis in older adults, requiring a multidisciplinary approach for optimal management.
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