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Transcatheter aortic-valve replacement with a self-expanding prosthesis Late kidney injury after transcatheter aortic valve replacement Frailty and Bleeding in Older Adults Undergoing TAVR or SAVR: Insights From the FRAILTY-AVR Study Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Implantation Precision Medicine in TAVR: How to Select the Right Device for the Right Patient Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients Prevalence and Outcomes of Concomitant Aortic Stenosis and Cardiac Amyloidosis Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Temporal Trends in Transcatheter Aortic Valve Replacement in France: FRANCE 2 to FRANCE TAVI Third-Generation Balloon and Self-Expandable Valves for Aortic Stenosis in Large and Extra-Large Aortic Annuli From the TAVR-LARGE Registry
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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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