European Geriatric Medicine xxx (2012) xxx–xxx

G Model

EURGER-295; No. of Pages 1

Editorial

Aortic valve diseases: Towards an innovative treatment

Available online at

www.sciencedirect.com

Valvular aortic stenosis in adults is progressive and lifethreatening. Adults with this disease have a poor prognosis andfrom the onset of symptoms if untreated will experienceworsening symptoms, eventually leading to death. Epidemiologi-cal studies estimate the prevalence of aortic stenosis at 5% insubjects over the age of 75 years. The European ESC guidelines onvalve replacement (established in 2007 [and updating in August])are clear for surgical valve replacement. Surgical valve replace-ment with sternotomy by a bioprosthesis has been provedeffective. Despite this, patients who, by the ESC guidelines, requirevalve replacement are often not treated. The Euro Heart Study, acomprehensive study of valve disease across Europe, has shownthat one third of the appropriate patients are not referred fromcardiologists for replacement. In the last five years, TranscatheterAortic Valve Implantation (TAVI) was been introduced in clinicalpractice. The results of the PARTNER Study (Cohort B, pivotalrandomized IDE TAVI study for inoperable patients) state that forthe patients enrolled in the study (average age 83 years) there wasa 20% absolute reduction in death from any cause at 1 year forthose patients treated with TAVI as compared to those treated withmedical management alone – a significant result showing thebreakthrough that TAVI offers for an unmet patient group in need.Until now, this research type was only performed by cardiologists/cardiac surgeon heart teams. The involvement of geriatricians isextremely welcomed. Prognostic and clinical value of Comprehen-sive Geriatric Assessment (CGA) is absolutely demonstrated in theGeriatric Literature.

This year, EUGMS established a special working group on aorticstenosis & TAVI and in June a questionnaire on aortic stenosis andTAVI was launched in Europe. The EUGMS would be extremelypleased gathering new inputs from the clinicians treating thesepatients by responding to its specific questionnaire on Europeanaortic valve patients.

In the next few months, the results of this survey will be ready.Moreover, the study group is planning an interdisciplinary study toevaluate CGA in all patients with aortic stenosis, before getting

Please cite this article in press as: Ungar A, Michel J-P. Aortic valve dishttp://dx.doi.org/10.1016/j.eurger.2012.08.001

1878-7649/$ – see front matter � 2012 Elsevier Masson SAS and European Union Ger

http://dx.doi.org/10.1016/j.eurger.2012.08.001

TAVI and after one and two years of follow-up. By this way, theEUGMS would like to stimulate, if not existing yet, a closecollaboration between cardiologists and geriatricians to allow theelderly patients suffering from aortic stenosis to benefit a of abetter functioning and quality of life & to improve our patient careaccording to guidelines with this new non-invasive proceduraloption.

All the European geriatricians have to be aware of thisimportant and innovative procedure for better treat the very oldand complex patients with aortic stenosis and get the best possibleoutcomes.

Disclosure of interest

The authors declare that they have no conflicts of interestconcerning this article.

A. Ungara,1, J.-P. Michelb,*,1aUnit of Gerontology and Geriatric Medicine, Department of Critical

Care Medicine and Surgery, University of Florence, ItalybGeneva University, Switzerland

*Corresponding authorE-mail addresses: aungar@unifi.it (A. Ungar)

jean-pierre.michel@unige.ch( J.-P. Michel)

1On behalf of the EUGMS working group on TAVI.

31 July 201231 July 2012

Available online xxx

eases: Towards an innovative treatment. Eur Geriatr Med (2012),

iatric Medicine Society. All rights reserved.