Transcatheter aortic valve implantation in an elderly patient with severe calcific aortic stenosis: a case report

Calcific aortic stenosis is the most common valvular heart disease in elderly and senile patients. The prevalence of degenerative aortic stenosis increases with age. According to several authors, the prevalence of degenerative aortic stenosis ranges from 1.3% in individuals aged 65 to 74 years to 6% in those over 85 years of age. Severe symptomatic calcific aortic stenosis is associated with high mortality, reaching 50% within two years after symptom onset. Aortic valve replacement is the only treatment for severe degenerative aortic stenosis and can be performed either surgically or transcatheterly. The choice between these approaches depends on patient age, life expectancy, anatomical features, comorbidity, and the experience and resources of the treating institution. Transcatheter aortic valve implantation (TAVI) is the method of choice in elderly patients (over 75 years), in patients at high surgical risk (STS-PROM, EuroSCORE II > 8%), or in those deemed inoperable by a multidisciplinary heart team. This article presents a clinical case of successful transfemoral TAVI in an 84‑year-old female patient with severe calcific aortic stenosis. We provide a detailed analysis of preoperative data (including multislice computed tomography anatomy and risk stratification), intraoperative stages of the procedure, and echocardiographic follow-up results up to 12 months. Using this case as an example, we demonstrate the selection criteria and technical aspects of endovascular treatment, and also review current literature evidence supporting the efficacy and safety of TAVI in the oldest age group.