{"id":8985,"date":"2025-10-21T09:35:48","date_gmt":"2025-10-21T06:35:48","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8985"},"modified":"2025-10-21T09:35:48","modified_gmt":"2025-10-21T06:35:48","slug":"is-it-reasonable-to-treat-asymptomatic-severe-aortic-stenosis-in-2025","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/is-it-reasonable-to-treat-asymptomatic-severe-aortic-stenosis-in-2025\/","title":{"rendered":"Is It Reasonable to Treat Asymptomatic Severe Aortic Stenosis in 2025?"},"content":{"rendered":"<div>Is It Reasonable to Treat Asymptomatic Severe Aortic Stenosis in 2025?<\/div>\n<div><\/div>\n<div>Source: Medscape Cardiology\u060c October 13, 2025<\/div>\n<div><\/div>\n<div>Keynotes:<\/div>\n<div><span> 1. Main Question: Should asymptomatic severe aortic stenosis (AS) be treated early, especially with TAVR?<\/span><\/div>\n<div><span> 2. Against (Dr. Mandrola):<\/span><\/div>\n<div><span> \u2022 Evidence remains weak; small trials (RECOVERY, AVATAR, EVOLVED) show no mortality benefit.<\/span><\/div>\n<div><span> \u2022 EARLY TAVR reduced hospitalizations, but mainly due to trial bias and crossover effects.<\/span><\/div>\n<div><span> \u2022 Observation remains safe; early intervention does not meet the evidentiary threshold.<\/span><\/div>\n<div><span> 3. For (Dr. Cohen):<\/span><\/div>\n<div><span> \u2022 Early TAVR may prevent sudden deterioration and reduce heart failure hospitalizations.<\/span><\/div>\n<div><span> \u2022 Reasonable in older or high-risk patients, but still not Class I evidence.<\/span><\/div>\n<div><span> 4. Meta-Analysis:<\/span><\/div>\n<div><span> \u2022 Combined data show no reduction in mortality or CV death, only fewer emergency admissions.<\/span><\/div>\n<div><span> 5. Guidelines (2025 Updates):<\/span><\/div>\n<div><span> \u2022 US (2020): Class I \u2014 intervene only if LVEF &lt; 50% or combined surgery is planned.<\/span><\/div>\n<div><span> \u2022 Europe (2025): Class IIa \u2014 consider early intervention in patients with rapid progression, LV dysfunction, or very high gradient defined as:<\/span><\/div>\n<div><span> \u2022 Peak aortic jet velocity (Vmax) \u2265 5.0 m\/s, or<\/span><\/div>\n<div><span> \u2022 Maximum pressure gradient (PGmax) \u2265 100 mmHg, or<\/span><\/div>\n<div><span> \u2022 Mean gradient \u2265 60 mmHg.<\/span><\/div>\n<div><span> 6. Consensus:<\/span><\/div>\n<div><span> \u2022 TAVR \u2248 SAVR in 5-year outcomes for low-risk patients.<\/span><\/div>\n<div><span> \u2022 Decisions should rely on Heart-Team assessment and shared decision-making.<\/span><\/div>\n<div><span> 7. Key Point:<\/span><\/div>\n<div><span> \u2022 No proven survival benefit yet for early TAVR\/SAVR in asymptomatic severe AS.<\/span><\/div>\n<div><span> \u2022 Management should be individualized, emphasizing patient risk, anatomy, and access to timely care.<\/span><\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.medscape.com\/viewarticle\/it-reasonable-treat-patients-asymptomatic-severe-aortic-2025a1000q8j?utm_source=chatgpt.com\">https:\/\/www.medscape.com\/viewarticle\/it-reasonable-treat-patients-asymptomatic-severe-aortic-2025a1000q8j?utm_source=chatgpt.com<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Is It Reasonable to Treat Asymptomatic Severe Aortic Stenosis in 2025? Source: Medscape Cardiology\u060c October 13, 2025 Keynotes: 1. Main Question: Should asymptomatic severe aortic stenosis (AS) be treated early, especially with TAVR? 2. Against (Dr. Mandrola): \u2022 Evidence remains weak; small trials (RECOVERY, AVATAR, EVOLVED) show no mortality benefit. \u2022 EARLY TAVR reduced hospitalizations, [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8985","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8985","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8985"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8985\/revisions"}],"predecessor-version":[{"id":8986,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8985\/revisions\/8986"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8985"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8985"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8985"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}