How do you approach the management of aortic stenosis in an elderly, frail patient with multiple comorbidities who is symptomatic but considered high risk for surgical aortic valve replacement?

In an older patient with severe aortic stenosis (AS) who is not a candidate for surgery, there are 3 treatment options – TAVR, balloon aortic valvuloplasty (BAV), and medical management.

In the original PARTNER trial, 358 patients with severe AS who, in the judgement of at least 2 cardiac surgeons, w...

I suppose although he is elderly and frail but symptomatic meaning the patient can ambulate? We don’t really have enough information on the patient’s history and physical capabilities and comorbid conditions. As well as the nature of his symptoms (Is it angina, syncope or heart failure) to give a re...

What are the benefits of a procedure?

1. Prolong life
2. Avoid hospitalizations
3. Improve quality of life (QOL). Symptom amelioration
4. Prevent CHF??
5. Co-morbidity reduction

Truth be told, many very elderly patients have sedentary lifestyles and don't need the purported boost a TAVR may give.

In other words,...