Author + information
- Received January 3, 2018
- Revision received March 9, 2018
- Accepted March 22, 2018
- Published online April 30, 2018.
- Susheel K. Kodali, MDa,∗ (, )
- Poonam Velagapudi, MD, MSa,
- Rebecca T. Hahn, MDa,
- Dawn Abbott, MDb and
- Martin B. Leon, MDa
- aColumbia University Medical Center/New York Presbyterian Hospital, New York, New York
- bBrown University, Providence, Rhode Island
- ↵∗Address for correspondence:
Dr. Susheel K. Kodali, Columbia University Medical Center, New York-Presbyterian Hospital, 177 Fort Washington Avenue, New York, New York 10032.
In the United States, the octogenarian population is projected to triple by 2050. With this aging population, the prevalence of valvular heart disease (VHD) is on the rise. The etiology, approach to treatment, and expected outcomes of VHD are different in the elderly compared with younger patients. Both stenotic and regurgitant lesions are associated with unfavorable outcomes if left untreated. Surgical mortality remains high due to multiple co-morbidities, and long-term survival benefit is dependent on many variables including valvular pathology. Quality of life is an important consideration in treatment decisions in this age group. Increasingly, octogenarian patients are receiving transcatheter therapies, with transcatheter aortic valve replacement having the greatest momentum. Numerous transcatheter devices for management of other valve lesions are currently in early clinical trials. This review will describe the epidemiology, etiology, diagnosis, and therapeutic options for VHD in the oldest old, with a focus on transcatheter technologies.
Dr. Kodali has served as a consultant for and received honoraria from Claret Medical, Merrill Lifesciences, and Abbott Vascular; served on the advisory board and received equity from Thubrikar Aortic Valve, Inc., Dura Biotech, Microinterventional Devices, and Biotrace Medical; and has served on the PARTNER trial steering committee, for which he received no compensation. Dr. Hahn has served on the Core Lab for multiple aortic intervention trials for which she has received no direct compensation. Dr. Leon has served as a member of the PARTNER Trial Executive Committee, for which he receives no direct compensation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 3, 2018.
- Revision received March 9, 2018.
- Accepted March 22, 2018.
- 2018 American College of Cardiology Foundation