Document Detail


Aortic stenosis in the elderly: Challenges in diagnosis and therapy.
MedLine Citation:
PMID:  22018632     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Severe aortic valve stenosis, remains the main cause of morbidity and mortality in the elderly, reaching a prevalence of 2-7% above the age of 65years old. Despite its frequency and the development in invasive and noninvasive approach of the disease, several of its aspects remain controversial. This review is focused on the clinical aspects, the indices for assessment severity, newly markers related to prognosis and new therapeutic modalities for the elderly population. The term low flow, low gradient severe aortic stenosis with preserved LV systolic function has revealed a new modality in the field of diagnostic evaluation and therapeutic approach. Aortic valve replacement is the choice therapy for symptomatic severe aortic stenosis. Despite the recent advances in cardiac surgery, the overall operative mortality rate for isolated aortic valve replacement surgery ranges from 2.5% to 4.0% and is higher in octogenarians and can be up to 25% in patients with comorbid conditions. The fact that surgery is not being performed for 30% or more of patients requiring it, a great attention was attracted to the percutaneous transcatheter implantation of a stent-mounted aortic valve. The up to now experience of transcatheter valve implantation in more than 25,000 patients, has shown promising results in terms of mortality and quality of life. Echocardiography still plays the central role for the evaluation of the elderly patient, as it can illustrate the pathophysiological alterations during the course of aortic valve stenosis, and guide appropriate therapy.
Authors:
Christina Chrysohoou; Dimitris Tsiachris; Christodoulos Stefanadis
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-19
Journal Detail:
Title:  Maturitas     Volume:  -     ISSN:  1873-4111     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7807333     Medline TA:  Maturitas     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
1st Cardiology Clinic, University of Athens, Greece.
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