Timing of Intervention in Aortic Stenosis

This editorial discusses the optimal timing of surgical intervention for aortic stenosis, referencing a trial by Kang et al. in which patients with asymptomatic, very severe aortic stenosis had significantly better outcomes with early valve replacement compared to conservative care. The authors highlight that symptom-based decision-making may be unreliable, particularly in elderly patients or those with lifestyle limitations. They emphasize disease staging as a more precise strategy, integrating hemodynamic data, structural abnormalities, and biomarkers to guide management. The piece calls for more randomized trials to evaluate early transcatheter interventions and encourages dedicated valve clinics for proactive risk stratification and follow-up.

This editorial discusses the optimal timing of surgical intervention for aortic stenosis, referencing a trial by Kang et al. in which patients with asymptomatic, very severe aortic stenosis had significantly better outcomes with early valve replacement compared to conservative care. The authors highlight that symptom-based decision-making may be unreliable, particularly in elderly patients or those with lifestyle limitations. They emphasize disease staging as a more precise strategy, integrating hemodynamic data, structural abnormalities, and biomarkers to guide management. The piece calls for more randomized trials to evaluate early transcatheter interventions and encourages dedicated valve clinics for proactive risk stratification and follow-up.