BACKGROUND: Many older patients with severe aortic stenosis do not have valve replacement surgery. OBJECTIVE: To determine the proportion of older people with symptomatic aortic stenosis referred for specialist assessment and the reasons for non-referral. METHODS: Retrospective study of all patients over 75 attending the geriatric department of an English teaching hospital. Confirmation was by reviewing all echocardiographic reports. RESULTS: Of 40 patients with symptomatic aortic stenosis, only four had undergone surgery. Seven patients refused operation; five were medically unfit (for reasons other than heart failure) and reasons for not referring could not be found in 13 casenotes. Of the 15 patients referred to a cardiologist, eight were considered suitable for surgery. CONCLUSION: Only one in five patients over 75 with echocardiographically-confirmed aortic stenosis was considered for surgery. Prospective studies are needed to determine why patients and geriatricians do not seek specialist assessment for this treatable condition.
BACKGROUND: Many older patients with severe aortic stenosis do not have valve replacement surgery. OBJECTIVE: To determine the proportion of older people with symptomatic aortic stenosis referred for specialist assessment and the reasons for non-referral. METHODS: Retrospective study of all patients over 75 attending the geriatric department of an English teaching hospital. Confirmation was by reviewing all echocardiographic reports. RESULTS: Of 40 patients with symptomatic aortic stenosis, only four had undergone surgery. Seven patients refused operation; five were medically unfit (for reasons other than heart failure) and reasons for not referring could not be found in 13 casenotes. Of the 15 patients referred to a cardiologist, eight were considered suitable for surgery. CONCLUSION: Only one in five patients over 75 with echocardiographically-confirmed aortic stenosis was considered for surgery. Prospective studies are needed to determine why patients and geriatricians do not seek specialist assessment for this treatable condition.
Authors: John A Bracken; Giovanni DeCrescenzo; Philip Komljenovic; Prasheel V Lillaney; Rebecca Fahrig; J A Rowlands Journal: Med Phys Date: 2009-05 Impact factor: 4.071