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Aortic stenosis in the elderly: challenges in diagnosis and therapy
Christina Chrysohoou1, Dimitris Tsiachris, Christodoulos Stefanadis
11st Cardiology Clinic, University of Athens, Athens, Greece. chrysohoou@usa.net
Maturitas
|October 25, 2011
Summary
Severe aortic valve stenosis affects 2-7% of adults over 65. This review covers clinical aspects, prognosis markers, and new therapies like transcatheter valve implantation, offering hope for elderly patients.
Area of Science:
- Cardiology
- Geriatrics
- Medical Technology
Background:
- Severe aortic valve stenosis is a prevalent condition in the elderly, contributing significantly to morbidity and mortality.
- Despite advances, aspects of diagnosis and treatment for this condition remain debated.
- The prevalence of severe aortic valve stenosis increases with age, affecting 2-7% of individuals over 65.
Purpose of the Study:
- To review clinical aspects, severity assessment indices, prognostic markers, and novel therapeutic strategies for severe aortic valve stenosis in the elderly.
- To discuss the diagnostic and therapeutic implications of low flow, low gradient severe aortic stenosis with preserved left ventricular systolic function.
- To evaluate the role of transcatheter valve implantation as an alternative to surgical aortic valve replacement.
Main Methods:
- Literature review focusing on clinical manifestations, diagnostic tools, and treatment options for severe aortic valve stenosis in older adults.
- Analysis of current data on surgical aortic valve replacement outcomes and the emerging role of percutaneous transcatheter valve implantation.
- Emphasis on the utility of echocardiography in evaluating elderly patients with aortic valve stenosis.
Main Results:
- Aortic valve replacement is the primary treatment for symptomatic severe aortic stenosis, but surgical risks are elevated in the elderly and those with comorbidities.
- Transcatheter valve implantation shows promising results, with over 25,000 procedures demonstrating reduced mortality and improved quality of life.
- Echocardiography remains crucial for assessing pathophysiological changes and guiding therapeutic decisions in elderly patients.
Conclusions:
- Transcatheter valve implantation offers a viable and effective alternative for patients with severe aortic valve stenosis, particularly for those at high surgical risk.
- Continued research and technological advancements are crucial for optimizing the management of severe aortic valve stenosis in the aging population.
- Accurate diagnostic evaluation, including echocardiography, is essential for tailoring treatment strategies and improving outcomes.
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