Conservative treatment of severe aortic stenosis in a 86-year-old female patient

    Authors

    Keywords

    aortic stenosis, conservative treatment, elderly patient

    DOI

    https://doi.org/10.15836/ccar2016.627

    Full Text

    Aortic stenosis is the most common valvular disease in Europe and the USA and its prevalence increases with age. It is a disease characterized with a relatively benign course during the asymptomatic period. However, once it becomes symptomatic, survival dramatically decreases. Overall life expectancy during the symptomatic period without age adjustment is about 15 to 50%. Considering available treatment modalities, more and more elderly patients are referred to invasive treatment. ( 1 - 3 ) We would like to present a female patient M.N., aged 89, who is under medical supervision in our hospital for severe aortic stenosis. She was first admitted to Intensive Care Unit in 2013 due to pulmonary edema and atrial fibrillation with ventricular tachyarrhythmia. She was then mechanically ventilated. Her previous medical history was significant for arterial hypertension and hypothyreosis. After initial stabilization a transthoracic echocardiography was performed, which showed a severe aortic stenosis with a PG of 75 mmHg, MPG 51 mmHg and AVA 0.7 cm 2 , a moderate mitral and tricuspid regurgitation and PAPs 65 mmHg. The patient responded well to treatment and was referred to invasive diagnostics. No significant coronary artery disease was found. She was then presented on a surgical meeting where, considering her age, a very high operative risk and good response to conservative treatment, a decision was made not to operate on her. The patient herself was not prone to surgery. After that she continued medical treatment under supervision of physicians in our hospital. With occasional short hospital stays and titration of diuretic and antiarrhythmic treatment a good quality of life was achieved. The patient is independent in her life activities and has no major symptoms. We find this case an argument for maximal individualization of severe aortic stenosis treatment in the elderly.

    Cardiologia Croatica
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    Conservative treatment of severe aortic stenosis in a 86-year-old female patient

    Extended Abstract
    Issue12
    Published
    Pages627
    PDF via DOIhttps://doi.org/10.15836/ccar2016.627
    aortic stenosis
    conservative treatment
    elderly patient

    Authors

    Maja Jelinić*ORCIDCroatia
    Nedeljko CiglenečkiORCIDCroatia
    Valentina SlivnjakORCIDCroatia

    Full Text

    Aortic stenosis is the most common valvular disease in Europe and the USA and its prevalence increases with age. It is a disease characterized with a relatively benign course during the asymptomatic period. However, once it becomes symptomatic, survival dramatically decreases. Overall life expectancy during the symptomatic period without age adjustment is about 15 to 50%. Considering available treatment modalities, more and more elderly patients are referred to invasive treatment. ( 1 - 3 ) We would like to present a female patient M.N., aged 89, who is under medical supervision in our hospital for severe aortic stenosis. She was first admitted to Intensive Care Unit in 2013 due to pulmonary edema and atrial fibrillation with ventricular tachyarrhythmia. She was then mechanically ventilated. Her previous medical history was significant for arterial hypertension and hypothyreosis. After initial stabilization a transthoracic echocardiography was performed, which showed a severe aortic stenosis with a PG of 75 mmHg, MPG 51 mmHg and AVA 0.7 cm 2 , a moderate mitral and tricuspid regurgitation and PAPs 65 mmHg. The patient responded well to treatment and was referred to invasive diagnostics. No significant coronary artery disease was found. She was then presented on a surgical meeting where, considering her age, a very high operative risk and good response to conservative treatment, a decision was made not to operate on her. The patient herself was not prone to surgery. After that she continued medical treatment under supervision of physicians in our hospital. With occasional short hospital stays and titration of diuretic and antiarrhythmic treatment a good quality of life was achieved. The patient is independent in her life activities and has no major symptoms. We find this case an argument for maximal individualization of severe aortic stenosis treatment in the elderly.