The most common forms of valvular heart disease in geriatric patients are mitral regurgitation and aortic stenosis. Although aortic regurgitation and mitral stenosis are seen in elderly patients, these are much less prevalent and they seldom arise de novo in this age group. The isolated forms of both of these entities are, to a large extent, 'disorders of aging' of the cardiovascular system. Meticulous follow-up is warranted in these patients to determine the proper time to intervene surgically. The treatment for symptomatic patients with severe aortic stenosis is replacement of the valve. Balloon aortic valvuloplasty can occasionally be used as palliation in those patients who are not candidates for an operation or to hemodynamically improve a patient until more definitive therapy can be undertaken. The approach to mitral regurgitation is becoming much more aggressive as the surgical techniques for valve repair and reconstruction are refined. Whereas in previous years, the approach to patients with severe mitral regurgitation was to use only medical therapy until the development of symptoms or signs of left ventricular dysfunction, earlier surgical intervention is now becoming routine. If surgery is delayed, it is possible that the patient may miss the window of opportunity to have the optimal surgical procedure performed: mitral valve repair.
- aortic stenosis
- mitral regurgitation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine