Population aging in industrialized countries and advances in surgical care are leading to an increased number of elderly patients referred for surgical management of aortic stenosis (AS). Our report is a retrospective review of 988 consecutive patients aged 80 to 93 years (mean 82.4 +/- 2.3) who had aortic valve replacement (AVR) for AS. Surgical mortality was 9.4% (93 patients). Among 895 operative survivors, follow-up rate has been 99.7%, total 4446 patient-years (mean 5 +/- 3 years, max 19 years). Actuarial survival including operative mortality was 82%, 59% and 23% at two, five and ten years respectively. Functionnal recovery was excellent (46 % NYHA I and 43% NYHA II). Long term survival paralleled that of age and sex matched control population. Age itself is no longer a contraindication to surgery and AVR is the procedure of choice for elderly patients with aortic stenosis. Percutaneous aortic valve implantation is feasible and requires evaluation. It might become an alternative for selected high-risk non surgical patients with AS.
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