Predictors of Outcome in Severe, Asymptomatic Aortic Stenosis

The poor outcome of patients with symptomatic aortic stenosis has been well documented. 1 – 10 In view of the excellent results of aortic-valve replacement, 2 , 11 – 16 surgery is strongly recommended for these patients. 17 In contrast, the management of asymptomatic aortic stenosis remains controversial. 17 The occurrence of sudden death without preceding symptoms 1 , 4 , 18 and the potential risk of irreversible myocardial damage 14 , 19 argue for early elective surgery. However, prospective studies suggest that, in the absence of preceding symptoms, sudden death may be uncommon. 20 , 21 Nevertheless, in 1997, Otto et al. reported rapid progression and poor outcomes among patients with asymptomatic aortic . . .