Asymptomatic patients with very severe aortic stenosis-operate or watch?

Content Provider	Europe PMC
Author	Narayan, Pradeep
Abstract	The Randomized Comparison of Early Surgery versus Conventional Treatment in Very Severe Aortic Stenosis (RECOVERY) trial has for the first time compared the strategy of surgery or observation in a randomized fashion. This was a prospective, randomized, multi-center trial that included 145 patients in total. Median follow-up was for just over 6 years. During follow-up, the rate of sudden death was 14% at 8 years in the conservative strategy group and 74% of the patients crossed over from the conservative treatment to the surgery arm. The main issues with the trial were inclusion of patients who may have already met the class IIa criteria for aortic valve replacement, as well as inability to accurately assess patients for presence of symptoms at the time of randomization. While the trial confirms that patients with very severe aortic stenosis do have a poor long-term outcome, because of the study design limitations, it does not confirm a definitive argument for early intervention.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8079470&blobtype=pdf
ISSN	09709134
Volume Number	37
DOI	10.1007/s12055-020-01135-4
PubMed Central reference number	PMC8079470
Issue Number	3
PubMed reference number	33967436
Journal	Indian Journal of Thoracic and Cardiovascular Surgery [Indian J Thorac Cardiovasc Surg]
e-ISSN	09737723
Language	English
Publisher	Springer Singapore
Publisher Date	2021-02-02
Publisher Place	Singapore
Access Restriction	Open
Rights License	© Indian Association of Cardiovascular-Thoracic Surgeons 2021
Subject Keyword	Very severe aortic stenosis Asymptomatic aortic stenosis RECOVERY trial
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine