Why the study?
The prognostic value of echocardiographic evidence of left ventricular remodeling for timing of aortic valve replacement in asymptomatic patients with severe aortic stenosis needed evaluation.
Does asymptomatic aortic valve replacement improve outcomes compared to conservative management in asymptomatic patients with severe aortic stenosis and preserved ejection fraction?
Population
160 asymptomatic patients with severe aortic stenosis and preserved ejection fraction
Comparison
AVR prior to vs after the development of symptoms
Design
Single-institutional retrospective study
Authors
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May support early AVR in asymptomatic severe AS; leaves open need for RCTs before practice change.
Does asymptomatic aortic valve replacement improve outcomes compared to conservative management in asymptomatic patients with severe aortic stenosis and preserved ejection fraction?
Early aortic valve replacement in asymptomatic patients with severe aortic stenosis and preserved ejection fraction is associated with a significantly lower risk of mortality, MI, stroke, and heart failure readmission compared to waiting for symptom onset.
Mikami et al. (2026) studied this question.
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