Survival in elderly patients with severe aortic stenosis is dramatically improved by aortic valve replacement: results from a cohort of 277 patients aged ≥80 years☆

Varadarajan, Padmini; Kapoor, Nikhil; Bansal, Ramesh; Pai, Ramdas G.

doi:10.1016/j.ejcts.2006.07.028

Cited by 197 publications

(122 citation statements)

References 16 publications

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“…Still, 41% of these patients with severe symptomatic AVS were treated medically. A similar survival pattern was observed in the study by Varadarajan and coworkers (Varadarajan et al, 2006). In their hands, surgically treated patients showed improved 1-year, 2-year and 5-year survival rates of 87, 78 and 68%, respectively, as compared with 52, 40 and 22%, respectively, in those managed medically.…”

Section: Natural History Of Aortic Stenosis and Conventional Treatmentsupporting

confidence: 67%

Aortic Stenosis: Geriatric Considerations

Risteski¹,

Zierer²,

Papadopoulos³

et al. 2011

Aortic Stenosis - Etiology, Pathophysiology and Treatment

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Section: Natural History Of Aortic Stenosis and Conventional Treatmentsupporting

confidence: 67%

Aortic Stenosis: Geriatric Considerations

Risteski¹,

Zierer²,

Papadopoulos³

et al. 2011

Aortic Stenosis - Etiology, Pathophysiology and Treatment

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“…Although aortic stenosis (AS) is robustly associated with adverse outcomes,2, 3 aortic sclerosis has also been associated with an increased risk of cardiovascular morbidity and mortality,4 and aortic sclerosis is a significant risk factor for progression to AS 5. More important, AV calcification and stenosis are associated with similar risk factors as atherosclerosis,1, 6, 7 and a wealth of data now point towards parallel active processes leading to AV dysfunction, including inflammation, lipid deposition, and calcification 8…”

Section: Introductionmentioning

confidence: 99%

Ideal Cardiovascular Health and the Prevalence and Severity of Aortic Stenosis in Elderly Patients

Sengeløv

Cheng

Biering‐Sørensen

et al. 2018

JAHA

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BackgroundThe relationship between ideal cardiovascular health reflected in the cardiovascular health score (CVHS) and valvular heart disease is not known. The purpose of this study was to determine the association of CVHS attainment through midlife to late life with aortic stenosis prevalence and severity in late life.Methods and ResultsThe following 6 ideal cardiovascular health metrics were assessed in ARIC (Atherosclerosis Risk in Communities) Study participants at 5 examination visits between 1987 and 2013 (visits 1–4 in 1987–1998 and visit 5 in 2011–2013): smoking, body mass index, total cholesterol, blood pressure, physical activity, and blood glucose. Percentage attained CVHS was calculated in 6034 participants as the sum of CVHS at each visit/the maximum possible score. Aortic stenosis was assessed by echocardiography at visit 5 on the basis of the peak aortic valve velocity. Aortic stenosis was categorized sclerosis, mild stenosis, and moderate‐to‐severe stenosis. Mean age was 76±5 years, 42% were men, and 22% were black. Mean percentage attained CVHS was 63±14%, and the prevalence of aortic stenosis stages were 15.9% for sclerosis, 4.3% for mild stenosis, and 0.7% for moderate‐to‐severe stenosis. Worse percentage attained CVHS was associated with higher prevalence of aortic sclerosis (P<0.001 for trend), mild stenosis (P<0.001), and moderate‐to‐severe stenosis (P=0.002), adjusting for age, sex, and race.ConclusionsGreater attainment of ideal cardiovascular health in midlife to late life is associated with a lower prevalence of aortic sclerosis and stenosis in late life in a large cohort of older adults.

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“…Elective FS-AVR performed through FS has been deemed a safe procedure since it carries low morbidity and short/long-term mortality rates. Specifically, multiple studies found AVR to be associated with favorable long-term survivorship, with average times ranging between 6.2 and 11.2 years postsurgery depending on age [42,47]. As such, AVR (isolated or concomitant with coronary Table 2.…”

Section: Discussionmentioning

confidence: 99%

The economic value of rapid deployment aortic valve replacement via full sternotomy

et al. 2017

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Aim:To compare the economic value of EDWARDS INTUITY Elite™ (EIE) valve system for rapid-deployment aortic valve replacement (RDAVR) in a full sternotomy (FS) approach (EIE-FS-RDAVR) versus FS-AVR using conventional stented bioprosthesis. Data & methods:A simulation model to compare each treatment's 30-day inpatient utilization and complication rates utilized: clinical end points obtained from the TRANSFORM trial patient subset (EIE-FS-RDAVR) and a best evidence review of the published literature (FS-AVR); and costs from the Premier database and published literature. Results: EIE-FS-RDAVR costs $800 less than FS-AVR per surgery episode attributable to lowered complication rates and utilization. Combined with the lower mortality, EIE-FS-RDAVR was a superior (dominant) technology versus FS-AVR. Conclusion: This preliminary investigation of EIE-FS-RDAVR versus conventional FS-AVR found the EIE valve offered superior economic value over a 30-day period. Realworld analyses with additional long-term follow-up are needed to evaluate if this result can be replicated over a longer timeframe.

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Survival in elderly patients with severe aortic stenosis is dramatically improved by aortic valve replacement: results from a cohort of 277 patients aged ≥80 years☆

Abstract: Prognosis of medically managed severe calcific AS in the elderly patients is dismal. AVR appears to improve survival of these patients and should be strongly considered in the absence of other major comorbidities.

Cited by 197 publications

References 16 publications

Aortic Stenosis: Geriatric Considerations

Aortic Stenosis: Geriatric Considerations

Ideal Cardiovascular Health and the Prevalence and Severity of Aortic Stenosis in Elderly Patients

The economic value of rapid deployment aortic valve replacement via full sternotomy

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