Management of elderly patients with aortic valve disease

Increased life expectancy has resulted in a growing population of elderly people, among whom aortic stenosis is increasingly prevalent. For the majority of patients, the treatment of aortic stenosis is surgical, and every symptomatic patient should be considered for aortic valve replacement. Although operative mortality seems to be declining over time, a substantial number of patients do not undergo surgery because of excessive risk, advanced age, or treatment preference of either the patient or the physician. The challenge in the near future will be the enhancement of tools for proper clinical decision-making, so that patients can be stratified to appropriate treatment alternatives. Reports on the treatment of aortic valve stenosis should, therefore, include all patients presenting with the disease and not only those who receive surgery.