Are you too young?

At a time when the value of performing aortic valve replacement surgery on elderly patients with aortic stenosis (AS) was being questioned, we reported our findings of a formal decision analysis entitled “You’re Never Too Old” (1) that revealed survival benefit of surgical aortic valve replacement (SAVR) in symptomatic elderly AS patients. SAVR is currently widely accepted as a treatment of otherwise healthy patients in the upper decades of life who are suffering from severe symptomatic AS. In such patients SAVR improves survival, symptoms, and quality of life associated with this disease (2). With an increasingly aging population, aortic valve replacement is now the most common reason for valve replacement in Europe and North America. However, approximately one-third of otherwise eligible patients for SAVR do not undergo this procedure, due to increased surgical risk with advanced age and baseline comorbidities (3,4).