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[Aortic stenosis in the elderly]
1Service de cardiologie A Groupe hospitalier Bichat-Claude-Bernard 75877 Paris. bernard.iung@bch.ap-hop-paris.fr
Insights
Elderly patients with symptomatic aortic stenosis have higher perioperative risks but good long-term outcomes after surgery. Early surgical intervention improves prognosis and quality of life.
Area of Science:
- Cardiology
- Geriatric Medicine
Context:
- Aortic stenosis is increasingly prevalent in the elderly population.
- Elderly patients often present with advanced disease and comorbidities, increasing surgical risks.
Purpose:
- To analyze the characteristics, perioperative outcomes, and long-term prognosis of elderly patients undergoing aortic stenosis treatment.
- To provide guidance on the timing of surgical intervention in this demographic.
Summary:
- Elderly patients with aortic stenosis frequently have advanced disease and associated cardiac or extracardiac conditions, leading to higher perioperative morbidity and mortality.
- Despite initial risks, long-term prognosis after aortic valve surgery is favorable, with life expectancy and functional status comparable to the general population.
Impact:
- Highlights the importance of individualized risk-benefit assessment for surgical intervention in elderly patients with symptomatic aortic stenosis.
- Emphasizes avoiding delayed treatment to prevent disease progression and ensure optimal long-term outcomes.
Abstract:
Aortic stenosis is observed with an increasing frequency in the elderly. Main features in the elderly are the frequency of advanced stage of the heart disease, and of associated diseases, either cardiac, in particular coronary lesions, or extracardiac. This can explain that perioperative morbidity and mortality are higher than in younger patients. However, after the operative period, long-term prognosis is good. Life expectancy becomes similar to a general population and functional results are excellent. In case of symptomatic aortic stenosis in the elderly, the decision to operate should take into account an evaluation of the individual risk to benefit ratio, and avoid to differ the decision until an advanced stage of the disease.