Transcatheter aortic valve replacement in elderly patients

Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacementreduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despitethe good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement(TAVR) allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery andcardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications tosurgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. Inthis chapter, we review the background and clinical applications of TAVR in elderly patients.