Aortic stenosis and perioperative risk: the other obstructive defect

Whilst the prevalence of aortic valve stenosis (AS) increases with age (1), surgery restores age-corrected survival to near normal. In parallel with senescence, comorbidities are present, one such example being chronic obstructive pulmonary disease (COPD), which causes significant disability and is the third leading cause of death in the United Sates (2). The presence of COPD is associated with increased perioperative complications, and serve as a reason to deny a patient surgical intervention because of the increased surgical risk (3).