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Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve Replacement: Results From the DIRECTAVI Trial Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years Timing of Intervention in Aortic Stenosis Coronary Access After TAVR Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis Incidence and Outcomes of Surgical Bailout During TAVR : Insights From the STS/ACC TVT Registry Transcatheter Aortic Valve Replacement in Low-risk Patients With Bicuspid Aortic Valve Stenosis Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk
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EditorialNovember 16, 2019

JOURNAL：N Engl J Med. Article Link

Timing of Intervention in Aortic Stenosis

P Lancellotti, MA Vannan. Keywords: asymptomatic patients with severe aortic stenosis; treatment timing

ABSTRACT

Current guidelines require that in patients with severe aortic stenosis, symptoms related to the valvular disease be present for consideration of transcatheter aortic-valve replacement (TAVR) or surgical aortic-valve replacement.  In the absence of symptoms, only very severe aortic stenosis is an indication (class IIa) for intervention. Kang et al. now report in the Journal the results of a trial involving patients with asymptomatic, very severe aortic stenosis who were randomly assigned to surgical aortic-valve replacement or conservative care (clinical follow-up and observation). Outcomes (death during or within 30 days after surgery [operative mortality] or death from cardiovascular causes; death from . . .

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