Surgery for symptomatic aortic stenosis in the elderly: Still an excellent option

As a result of the aging of populations, aortic stenosis (AS) is rapidly turning into the cardiac epidemic of the 21st century, with an estimated incidence of about 10% in patients over 80 years of age. 1 This potentially lethal condition is still mainly treated by surgery, and patients' general condition, both physical and mental, after the operation is perceived as being at least as important as survival, especially in elderly patients.In a paper published in this issue of the Journal, 2 Bento et al. of the surgical group at Santa Marta Hospital in Lisbon set out to determine the impact of surgical aortic valve replacement (SAVR) on quality of life in octogenarians.In a retrospective analysis of 163 octogenarians (mean age 83 years) who underwent isolated SAVR for symptomatic severe AS between 2011 and 2015, quality of life was assessed by applying the Medical Outcomes Study Short Form (SF-36) questionnaire repeatedly up to 12 months after surgery.The authors came to the conclusion that SAVR improved the physical and mental health status of octogenarians with severe AS, and that this improvement was evident at three months and consistent at six and 12 months.Furthermore, it was observed in all eight domains of the questionnaire (physical function and performance, body pain, general and mental health, social functioning, emotional performance and vitality).The SF-36 survey