Victoria Delgado1,2, MD, PhD; Paolo Manca3, MD; Michele Senni3,4, MD, PhD
1. Heart Institute, Hospital Universitario Germans Trias i Pujol, Badalona, Spain; 2. Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; 3. Cardiology Unit, Cardiovascular Department, Hospital Papa Giovanni XXIII, Bergamo, Italy; 4. University of Milan-Bicocca, Milan, Italy
Pros: trials that challenge the guidelines
Victoria Delgado, MD, PhD
Current international guidelines recommend aortic valve replacement (AVR) in severe aortic stenosis (AS) if it is causing symptoms or left ventricular systolic dysfunction (left ventricular ejection fraction [LVEF] <50%). However, several registries have shown that performing AVR when symptoms or reduced LVEF occur is associated with poor outcomes. Staging algorithms that consider the extent of structural and/or functional alterations associated with AS help to refine the risk stratification of patients with severe AS1. Accordingly, the question that then arises is whether performing AVR in asymptomatic patients with severe ...