Key result
Integrating multimodal risk assessment and shared decision-making optimizes intervention timing in asymptomatic severe AS.
Why the study?
Recent randomized data challenge the historical paradigm of watchful waiting until symptom onset or guideline-defined triggers emerge in asymptomatic severe aortic stenosis.
What is the contemporary approach to managing asymptomatic severe aortic stenosis?
What is the contemporary approach to managing asymptomatic severe aortic stenosis?
This review proposes an individualized framework for managing asymptomatic severe aortic stenosis, challenging the historical watchful waiting paradigm with recent randomized data.
Challenges watchful waiting in asymptomatic severe AS; leaves open optimal intervention timing pending further trials.
Asymptomatic severe aortic stenosis (AS) is characterized by a prolonged latent phase during which progressive valvular obstruction and myocardial remodeling may occur despite preserved left ventricular ejection fraction and the absence of overt clinical symptoms. Historically, management has favored watchful waiting until symptom onset or guideline-defined triggers emerge; however, recent randomized data challenge this conservative paradigm. This review summarizes the natural history, risk stratification, and contemporary management of asymptomatic severe AS, with a focus on emerging insights that inform the timing of intervention. We propose an individualized, contemporary framework for managing asymptomatic severe AS that integrates multimodal risk assessment, procedural risk, and shared decision-making, and we outline future directions aimed at refining patient selection and optimizing the personalized timing of intervention.
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Desai et al. (2026) conducted a review in Asymptomatic severe aortic stenosis. A contemporary framework for managing asymptomatic severe aortic stenosis integrates multimodal risk assessment, procedural risk, and shared decision-making to optimize the timing of intervention.
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