Incidence, Determinants, and Prognostic Impact of Operative Refusal or Denial in Octogenarians With Severe Aortic Stenosis

About 40% of octogenarians with severe AS and a definite indication for operation either refuse or are denied AVR. AVR refusal or denial has a profound impact on long-term prognosis, resulting in a twofold excess mortality, even after adjustment for the propensity score.