In patients with symptomatic severe aortic stenosis (AS) therapeutic decision is straightforward and aortic valve replacement is strongly recommended. In asymptomatic AS patients clinical strategy is controversial and challenging. Prospective studies suggest a watchful waiting approach in the majority of patients with regular follow-up exams. Defining symptomatic status related to the disease can be particularly difficult in the elderly and patients with comorbidities. A robust measurement of AS severity is mandatory in this context. Nevertheless some patients with asymptomatic AS benefit from early valve replacement and reliable risk stratification for identification of high-risk patients is of importance. This review article will outline relevant clinical studies and guidelines on management of asymptomatic AS patients.
© Georg Thieme Verlag KG Stuttgart · New York.