Key result
The optimal management of asymptomatic severe aortic stenosis remains unclear, with current guidelines recommending a watchful waiting strategy until symptom development or systolic dysfunction occurs.
Highlights the clinical challenge of managing asymptomatic severe aortic stenosis under current watchful waiting guidelines.
A lthough the annual risk of cardiovascular mortality has been well described for individuals with symptomatic aortic stenosis, the morbidity and mortality for those with asymptomatic severe aortic stenosis is not as well known. Currently the American Heart Association/American College of Cardiology recommends a "watchful waiting" strategy for those with asymptomatic aortic stenosis. 1 This involves clinical examinations every 6 to 12 months and annual echocardiograms; however, it is unclear what to do with these data in the patient who remains asymptomatic. The asymptomatic patient is generally not referred for aortic valve replacement surgery until the development of symptoms (unless concurrent coronary artery bypass grafting is required or if systolic dysfunction develops).
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Coglianese et al. (2009) conducted an editorial in Asymptomatic severe aortic stenosis. Watchful waiting strategy vs. Aortic valve replacement surgery was evaluated. The optimal management of asymptomatic severe aortic stenosis remains unclear, with current guidelines recommending a watchful waiting strategy until symptom development or systolic dysfunction occurs.
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