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especially elderly patients. Broadening the indication for interventional treatment to elderly patients has focused on the effect of multiple comorbid conditions on progression of AS. However, its underlying etiology is still poorly understood.3 Valvular calcific degeneration has been thought to be ageassociated, but recent evidence suggests that it is rather the result of an active inflammatory process (Figure). Injury of the endothelium of the aortic valve from mechanical stress is the initial process, which is in many ways similar to that of atherosclerosis. Such injury may allow lipids to penetrate the ortic stenosis (AS) is the most common valvular heart disease in the elderly, affecting 2–4% of adults older than 65 years.1 The number of aortic valve replacements performed over the past decade has doubled, and the prevalence of AS is likely to double again in the next 20 years with an increasing elderly population.2 With recent advances in new therapeutic devices, such as transcatheter valve implantation, cardiologists have paid more attention to AS. This technique has given hope to patients who were unable to benefit from surgical treatment because of their high surgical risk, A

Does Major Noncardiac Surgery Accelerate the Progression of Aortic Stenosis? – Role of Inflammation –