Document resource
The timing of aortic valve replacement (AVR) in asymptomatic patients with severe aortic stenosis has been debated for several decades. Based on observational data and expert opinion, international guidelines recommend a conservative approach with close clinical surveillance. With improvements in surgical AVR and peri-operative care, there has been a trend for more asymptomatic patients to receive AVR and propensity-matched analyses have suggested benefit of early intervention. Furthermore, the advent of transcatheter aortic valve implantation (TAVI) has seen low peri-procedural risk and good medium-term safety data, leading many to question whether asymptomatic patients with severe aortic stenosis should now receive AVR or TAVI?