JHVS: Early Intervention Versus Clinical Surveillance in Asymptomatic Severe Aortic Stenosis: An Evidence-Based Update

And also, I would say at the same time, a viewpoint article by Dr. Sanchez Blanco and Zarate Correa and colleagues from Ishesi University in Cali, Colombia.

and Laval University in Quebec, Canada.

So the authors present an evidence-based update on early intervention versus clinical surveillance in asymptomatic patients with severe aortic stenosis.

And the answer conclude that contemporary evidence support a padding shift toward earlier intervention in selected asymptomatic patient with CVAS guided by multiple data assessment of myocardial structure and functional consequences.

However, the identification of optimal intervention threshold remains an active area of clinical investigation requiring careful integration of hemodynamic markers, advanced imaging, and individual risk profiles.

So, I mean, this review article of your point is timely because there has been several randomized trials that have been published in the past five years about the timing of intervention of Arctic valve replacement in asymptomatic patients with severe AS.

And following this evidence, the recent edition of the European guidelines published in September 2025 actually included a new class IIa indication with a level of evidence A. for early intervention in asymptomatic patients with severe AS and high gradient and low surgical risk.

So I think this viewpoint is advocating for maybe a more individualized approach than an all-comers approach and still continue to prioritize the asymptomatic patients who have some risk features for rapid progression or adverse outcomes.

So I think this is an interesting article to read, and that provides, I think, a complementary view versus what has been previously published.