Initial Surgical versus Conservative Strategies in Patients with Asymptomatic Severe Aortic Stenosis

The investigators in this registry study enrolled 3815 patients with asymptomatic aortic stenosis. Patients underwent either surgical aortic valve replacement (AVR) or conservative therapy. In order to increase comparability, they used propensity score matching to create two more similar groups. The cumulative 5-year incidences of all-cause death and heart failure hospitalization were significantly lower in the initial AVR group compared to the conservative group (15.4% vs. 26.4%, p=0.009 and 3.8% vs. 19.9%, p<0.001). Moreover, 41% of the patients in the conservative treatment group received AVR during follow-up. These results indicate that initial AVR in patients asymptomic severe aortic stenosis might be substantially improved by initial AVR.