Aortic valve replacement in the elderly: Frequently indicated yet frequently denied

Katrina A. Bramstedt*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

39 Citations (Scopus)


Background: The prevalence of aortic stenosis is nearly 20% in octogenarians. Aortic valve replacement (AVR) is the optimal therapy choice, yet many symptomatic patients are denied this beneficent technology. Whether mechanical or bioprosthetic, aortic valves are not a scarce resource and their safety, effectiveness and longevity are proven. 

Objective: Because the geriatric population is soaring, clinicians will be encountering more cases of aortic stenosis and the decision-making that leads to surgical referral or non-referral warrants exploration. 

Methods: A literature review was conducted to explore the notion that physicians deny AVR to their patients based solely on their chronological age value. Results: Using age as the sole exclusion criterion, medical literature documents the fact that AVR is frequently denied to the elderly. 

Conclusion: It appears that AVR is another beneficent cardiac technology that has been added to the age discrimination list, even though the devices are not scarce, they are cost-effective, and they can improve the life of a symptomatic elderly patient. There is no ethical justification for denying AVR to clinically suitable elderly candidates who request such therapy. 

Original languageEnglish
Pages (from-to)46-49
Number of pages4
Issue number1
Publication statusPublished - 2003
Externally publishedYes


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