Prolonged survival in 2 nonagenarians with heart failure and severe aortic stenosis

The prevalence of severe aortic stenosis is 6% in persons 85 to 86 years of age according to a Finnish population-based report. In the United States, the population over 80 years old is projected to rise from the current 7 million to 25 million by the year 2050. Thus, aortic stenosis in aging adults, and the management questions it poses, will be increasingly common. We report herein the cases of 2 nonagenarian patients with severe symptomatic aortic stenosis who far outlived the natural history of this disease. We suspect that we are seeing a change in the prognosis of senile aortic stenosis as a result of advances in the geriatric care and management of advanced heart failure. Furthermore, the unusual longevity of these patients was made possible by the remarkable holistic care given by a dedicated, altruistic caregiver who had training in psychology, theology, and nursing.