Why do so few older people with aortic stenosis have valve replacement surgery?
GROUND: Many older patients with severe aortic stenosis do not have valve replacement surgery. OBJECTIVE: To determine the proportion of older people with symptomatic aortic stenosis referred for specialist assessment and the reasons for non-referral. METHODS: Retrospective study of all patients over 75 attending the geriatric department of an English teaching hospital. Confirmation was by reviewing all echocardiographic reports. RESULTS: Of 40 patients with symptomatic aortic stenosis, only four had undergone surgery. Seven patients refused operation; five were medically unfit (for reasons other than heart failure) and reasons for not referring could not be found in 13 casenotes. Of the 15 patients referred to a cardiologist, eight were considered suitable for surgery. CONCLUSION: Only one in five patients over 75 with echocardiographically-confirmed aortic stenosis was considered for surgery. Prospective studies are needed to determine why patients and geriatricians do not seek speci
Related Questions
- Should aortic valve replacement be performed in an 80-year-old person with symptomatic severe aortic stenosis?
- Should the aortic valve be replaced in patients with mild aortic stenosis admitted for coronary surgery?
- Is it common to develop moderate aortic stenosis less than 1 year after valve replacement?
