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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 May;172(5):395-400

language: Italian

Aortic valve replacement in an elderly patient: a clinical case

Ettorre E., Servello A., Colella F., Marigliano B., Vulcano A., Cerra E., Viscogliosi G., Andreozzi P., Vigliotta M. T., Marigliano V.

Dipartimento di Scienze dell’Invecchiamento Sapienza Università di Roma, Roma, Italia


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Aortic stenosis (AS) is one of the most common valvular heart disease in the world. Because of an increase in the aging population, elderly patients with critical AS are more prevalent than before. The most recent epidemiological studies in Europe and in United States show a prevalence of moderate-severe aortic stenosis of 4.6% in the population aged > 75 years, reaching 8, 1% after 85 years. Valve replacement is the therapy of choice in patients with AS as it can significantly improve the prognosis and the quality of life. Although age is not a contradiction for surgical therapy, the correct exam of the patient is essential to plan the therapeutic path. Surgical results are satisfactory even in elderly population when a surgical candidate is appropriately selected. We analyzed the clinical case of a 78-years old patient suffering from severe aortic stenosis with concurrent cognitive impairment, focusing our attention on the multidimensional assessment that led to our decision to proceed with surgery despite the opposite indications of the guidelines.

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