Conversations in Interventional Cardiology - Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis-Conversations in Interventional Cardiology - Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis”

Conversations in Interventional Cardiology - Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis”

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Video Summary

A J-Sky discussion reviewed a systematic review and meta-analysis of 16 studies involving more than 5,000 patients with asymptomatic severe aortic stenosis. The analysis found that early aortic valve replacement (AVR), including TAVR and SAVR, was associated with lower all-cause and cardiovascular mortality overall, with the strongest mortality benefit seen in observational studies. Randomized trials showed clearer reductions in heart failure hospitalization and stroke, even when mortality benefits were less definitive. The panel emphasized that many “asymptomatic” patients are not truly symptom-free and that clinical surveillance can miss progression. Experts discussed how early intervention is shifting management toward earlier referral, heart-team evaluation, and individualized lifetime planning, especially given concerns about TAVR durability in younger patients. They agreed that there is little reason to delay treatment once severe AS is confirmed, and that better screening, imaging, and education are crucial.

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Keywords

asymptomatic severe aortic stenosis

early aortic valve replacement

TAVR and SAVR

mortality reduction

heart failure hospitalization

heart-team evaluation