June 27, 2026Expert Review of Cardiovascular Therapy0 citations
View Full PaperContemporary approach and key considerations to asymptomatic aortic stenosis treatment
Key Result
A review of asymptomatic severe aortic stenosis treatment highlights that the optimal intervention strategy versus clinical surveillance remains to be clarified by ongoing trials.
Key Points
- This research addresses treatment strategies for asymptomatic patients with high-gradient severe aortic stenosis.
- Comprehensive literature search through PubMed using key terms related to aortic stenosis and treatment strategies.
- Analysis of current ESC/EACTS guidelines for valvular diseases involving asymptomatic patients.
- Review of ongoing trials focusing on therapeutic options for high-gradient severe aortic stenosis.
- The latest ESC/EACTS guidelines indicate treatment for asymptomatic high-gradient severe aortic stenosis is now endorsed.
- Differences in patient characteristics necessitate clarification of optimal interventions for this population.
- Recommendations highlight the urgency for comparing TAVI and SAVR in randomized trials among middle-aged asymptomatic patients.
Structured PICO
What is the optimal treatment strategy (intervention vs. clinical surveillance) for asymptomatic patients with severe high-gradient aortic stenosis?
P
Population
Asymptomatic patients with high-gradient severe aortic stenosis without additional adverse factors such as decrease in left ventricular systolic function or increase in natriuretic peptides
I
Intervention
Early intervention (TAVI or SAVR)
C
Comparator
Clinical surveillance
This review supports the latest ESC/EACTS guidelines for early intervention in asymptomatic severe high-gradient aortic stenosis and highlights the need for further RCTs comparing TAVI and SAVR in middle-aged patients.
Abstract
INTRODUCTION Aortic stenosis is the most common and the deadliest valvular disease. The treatment of asymptomatic patients with severe AS is still a subject of investigation. Recently, ESC/EACTS guidelines for valvular diseases introduced a new indication for the treatment of asymptomatic low-risk patients with isolated high-gradient severe AS, as an alternative to clinical surveillanceAREA COVERED This paper attempts to provide a rational, clinically-oriented and evidence-based approach to the treatment of asymptomatic patients with high-gradient severe AS without additional adverse factors such as decrease in left ventricular systolic function or increase in natriuretic peptides. We searched for original and review papers through the PubMed database using the key words: aortic stenosis, asymptomatic, risk stratification and intervention while not limiting the time period of analyzed papersEXPERT OPINION The latest ESC/EACTS recommendations for the treatment of asymptomatic AS should be considered adequate. Considering differences in patient characteristics and heterogeneous treatment modalities, as well as differences in institutional-level outcomes, the optimal intervention strategy still needs clarification. Ongoing trials in asymptomatic patients with severe AS should provide significant new evidence. The diverse array of therapeutic options emphasizes the need for TAVI vs. SAVR randomized trial in middle-aged asymptomatic patients.
Cite This Study
Banović et al. (Fri,) conducted a review in asymptomatic aortic stenosis. Intervention (TAVI or SAVR) vs. Clinical surveillance was evaluated. A review of asymptomatic severe aortic stenosis treatment highlights that the optimal intervention strategy versus clinical surveillance remains to be clarified by ongoing trials.