Aortenklappenersatz beim älteren Patienten

Aortic valve procedures represent the second most frequent surgical intervention in cardiac surgery. Due to the demographic developments there is a shift into the seventh to ninth decade of age. For patients beyond 65 years biological valve prostheses are recommended. In these patients xenografts are showing only a slow degeneration. Furthermore, especially these patients are threatened by complications caused by cumarine therapy. Modern valve-sparing procedures might also be used in old patients with an insurable risk. Mortality is slightly increased in old patients compared to younger patients. However, additional risk factors like clinical stage as well as co-morbidity affect the mortality significantly. The specific operative procedure has to select with respect to the individual situation of the patient. In conclusion, aortic valve surgery should be taken into account also in older, symptomatic patients.