Trends in aortic valve replacement among patients with dementia

For patients who have a narrowed aortic valve that fails to open properly, transcatheter aortic valve replacement (TAVR) is a less invasive alternative to open surgical valve replacement. In a recent analysis published in Journal of the American Geriatrics Society that examined Medicare data from 2010 to 2016, rates of aortic valve replacement in individuals with Alzheimer’s disease and related dementias increased over time, largely driven by the use of TAVR.

In parallel, mortality rates after aortic valve replacement declined in this patient population.

The findings suggest that TAVR can be safely and effectively performed in patients with dementia.

“The introduction of TAVR opened the possibility of treatment for aortic stenosis to the vulnerable population of patients with Alzheimer’s disease and related dementias. Many of these patients were not candidates for surgical replacement as evidenced by the low rates of treatment in the early years of the study,” said lead author Brent K. Hollenbeck MD, MS, of the University of Michigan. “Importantly, in patients undergoing TAVR, 1 year mortality in those with Alzheimer’s disease and related dementias was very similar to that of other patients by the end of the study.”