Key result
Early valve replacement for asymptomatic severe AS guided by myocardial damage markers remains controversial.
Why the study?
Indications for valve replacement in severe aortic stenosis remain symptom-based, but advances in interventions have shifted focus toward identifying early markers of irreversible myocardial damage.
This review highlights the shift towards identifying early markers of myocardial damage to guide the timing of valve replacement in severe aortic stenosis before irreversible injury occurs.
Requires cautious individualized decisions in asymptomatic severe aortic stenosis; leaves open optimal timing guided by myocardial markers pending randomized trials.
Severe aortic stenosis is a progressive clinical entity that has historically developed alongside descriptions of pathological anatomy, cardiovascular semiology, heart surgery, and percutaneous cardiovascular interventions.Indication for valve replacement in patients with severe aortic stenosis is still based on symptom onset.With advances in surgical techniques, especially transcatheter implantation, the focus has shifted to identifying early markers of myocardial damage that may indicate irreversible myocardial injury.
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Daniel França Vasconcelos (2026) conducted a review in Severe aortic stenosis. Early valve replacement vs. Expectant management was evaluated. Early valve replacement in asymptomatic severe aortic stenosis based on early markers of myocardial damage remains controversial and requires individualized, multidisciplinary decision-making.
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