Early surgical valve replacement is better than watchful waiting in patients with severe but asymptomatic aortic stenosis, researchers report.

Speaking at the American Heart Association Scientific Sessions 2021 virtual meeting, Professor Marko Banovic described the results of the Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis (AVATAR) trial carried out at nine European hospitals.

All 157 patients (57% men, mean age 67) had asymptomatic severe aortic stenosis with normal left ventricular function and had undergone an exercise test to demonstrate that they were asymptomatic.

They were randomised to either surgery or watchful waiting and the trial was designed to end when 35 major adverse cardiac events (MACE) had accumulated.