Optimum management of elderly patients with calcified aortic stenosis.
Increased life-expectancy has led to a growing elderly population frequently presenting with aortic stenosis. This review focuses on the pathogenesis of calcific aortic stenosis, diagnosis and possible ways to halt the progression to severe symptomatic aortic stenosis, methods of assessing symptoms and severity, and modalities and timing of aortic valve replacement. At present the treatment of aortic stenosis for the majority of patients is surgical, and any patient with symptomatic severe aortic stenosis should be considered for aortic valve replacement. This article also discusses the role of emerging techniques of closed heart valve implantation either transfemoral or transapical, and which patients might be candidates for these new approaches to the treatment of aortic stenosis in the elderly population.
Kappetein
A Pieter
AP
Department of Cardio-thoracic Surgery, Erasmus Medical Center, Room Bd 569, PO Box 2040, 3000 CA Rotterdam, The Netherlands. a.kappetein@erasmusmc.nl
van Geldorp
Martijn
M
Takkenberg
Johanna J M
JJ
Bogers
Ad J J C
AJ
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002114:Calcinosis / Q000601:surgery*; D018450:Disease Progression; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors