Age and Ageing, Vol 28, 261-264, Copyright © 1999 by British Geriatrics Society
AR Abdul-Hamid and GP Mulley
BACKGROUND: Many older patients with severe aortic stenosis do not have
valve replacement surgery. OBJECTIVE: To determine the proportion of older
people with symptomatic aortic stenosis referred for specialist assessment
and the reasons for non-referral. METHODS: Retrospective study of all
patients over 75 attending the geriatric department of an English teaching
hospital. Confirmation was by reviewing all echocardiographic reports.
RESULTS: Of 40 patients with symptomatic aortic stenosis, only four had
undergone surgery. Seven patients refused operation; five were medically
unfit (for reasons other than heart failure) and reasons for not referring
could not be found in 13 casenotes. Of the 15 patients referred to a
cardiologist, eight were considered suitable for surgery. CONCLUSION: Only
one in five patients over 75 with echocardiographically-confirmed aortic
stenosis was considered for surgery. Prospective studies are needed to
determine why patients and geriatricians do not seek specialist assessment
for this treatable condition.
ARTICLES
Why do so few older people with aortic stenosis have valve replacement surgery?
Elderly Medicine, Seacroft Hospital, Leeds, UK.
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