Aortic Valve Surgery and Transcatheter Aortic Valve Replacement for the Very Old: Improved Interventional Therapeutic Options for Aortic Stenosis for Elderly

The older adult population in the U. S. (>75 years old) is growing rapidly with seniors living well into their 80s and 90s. Incidence of calcific valvular stenosis increases with age, and as a result, the prevalence of calcific valvular aortic stenosis (AS) is increasing. Elderly people with symptomatic AS are particularly vulnerable to mortality as well as to reduced quality of life and increased dependency. Trans-catheter aortic valve replacement (TAVR) has revolutionized the treatment options for those with AS, especially in older adults who were previously deemed non-surgical or high risk surgical candidates. Several reports have shown improvements in longevity, functional class and quality of life following TAVR in older adults. Surgical techniques for aortic valve replacement have also improved. This review will discuss clinical elements of AS and the dynamic field of interventional treatment options.