Does early valve replacement improve prognosis in asymptomatic patients with severe aortic stenosis who have moderate or severe valvular calcification and a rapid increase in aortic-jet velocity compared to delaying surgery until symptoms develop?
In asymptomatic severe aortic stenosis, moderate to severe valvular calcification and a rapid increase in aortic-jet velocity identify high-risk patients who should be considered for early valve replacement.
In asymptomatic patients with aortic stenosis, it appears to be relatively safe to delay surgery until symptoms develop. However, outcomes vary widely. The presence of moderate or severe valvular calcification, together with a rapid increase in aortic-jet velocity, identifies patients with a very poor prognosis. These patients should be considered for early valve replacement rather than have surgery delayed until symptoms develop.
Rosenhek et al. (2000) studied this question.