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Review
. 2023 Jun 27;7(5):100201.
doi: 10.1016/j.shj.2023.100201. eCollection 2023 Sep.

Asymptomatic Severe and Moderate Aortic Stenosis: Time for Appraisal of Treatment Indications

Marko Banovic  1   2 , Bernard Iung  3   4 , Wojtek Wojakowski  5 , Nicholas Van Mieghem  6 , Jozef Bartunek  7
Affiliations
Review

Asymptomatic Severe and Moderate Aortic Stenosis: Time for Appraisal of Treatment Indications

Marko Banovic et al. Struct Heart. .

Abstract

Over the last decades, we have witnessed considerable improvements in diagnostics and risk stratification of patients with significant aortic stenosis (AS), paralleled by advances in operative and anesthetic techniques. In addition, accumulating evidence points to the potential benefit of early valve replacement in such patients prior to the onset of symptoms. In parallel, interventional randomized trials have proven the benefit of transcatheter aortic valve replacement in comparison to a surgical approach to valve replacement over a broad risk spectrum in symptomatic patients with AS. This article reviews contemporary management approaches and scrutinizes open questions regarding timing and mode of intervention in asymptomatic patients with severe AS. We also discuss the challenges surrounding the management of symptomatic patients with moderate AS as well as emerging dilemmas related to the concept of a life-long treatment strategy for patients with AS.

Keywords: Aortic stenosis; Asymptomatic; Moderate; Treatment.

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Conflict of interest statement

Marko Banovic, Bernard Iung, Jozef Bartunek, Wojtek Wojakowski are investigators in the Avatar trial; Jozef Bartunek receives consultancy fees from Occlutech (unrelated to the topic of the manuscript). The other author had no conflicts to declare.

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