**1. Introduction**

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482 Calcific Aortic Valve Disease

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Rising life expectancy results in an increase of degenerative and neoplastic diseases. Popula‐ tion-based observational studies report that 1% to 2% of patients older than 65 years have moderate-to-severe aortic stenosis (AS) [1]. Surgical aortic valve replacement (AVR) dates back to 1960 and is currently the only treatment option for severe AS that has been shown to improve survival, regardless of age [2]. In the ideal candidate, surgical AVR has an estimat‐ ed operative mortality of 4% [2]. Unfortunately, up to one-third of patients with severe AS are ineligible for corrective valve surgery, either because of advanced age or the presence of multiple comorbidities [3]. Current treatment options for those patients not offered surgery include medical treatment or percutaneous balloon aortic valvuloplasty, although neither has been shown to reduce mortality. Medically treated patients with symptomatic AS have 1- and 5-year survival of 60% and 32%, respectively [4,5]. With the introduction of percuta‐ neous aortic valve implantation in 2002, there seems to be an alternative for these patients.
