Editorial
Cardiac surgery in the elderly: a cardiologist's perspective
| The first 150 words of the full text of this article appear below. |
It is
axiomatic that symptomatic aortic stenosis is a malignant condition for
which the only effective treatment is valve replacement.1
Of course, several factors other than the state of the valve have to be
considered before surgery is recommended to a patient. Important among
these are the presence and severity of other disease, and the estimated
risks of perioperative death or serious complications. Decision making
is often difficult in the case of elderly patients
arbitrarily taken
to mean those aged 70 and olderin whom weighing the risks and
benefits of surgery may be a complex matter. How do the studies in this
issue2-4 contribute to the evidence base on which our
advice should stand?
Bouma and colleagues from the Netherlands2 report an
observational study of 205 patients aged 70 and older (33% 
80
years) who were identified by Doppler echocardiography as having an
aortic valve area of < 1 cm2 or a maximum aortic
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