What would be your approach for the management of asymptomatic, severe AS with a peak velocity of 5 m/s in an otherwise physically active patient in their mid-90s without significant co-morbidities?

The EARLY TAVR trial (Généreux et al,. PMID 39466903) showed that in patients with asymptomatic severe AS, early TAVR was associated with a 50% reduction in the primary composite endpoint of death, stroke, or unplanned hospitalization for cardiovascular causes compared to clinical surveillance over ...

Agree with Dr. @Dr. First Last that the shared decision-making discussion precedes the referral for TAVR evaluation.

Agree. A unicorn of a patient to some degree. Shared decision-making is key here in a patient who is doing so well. A lot of this may depend on his interest (or disinterest) in procedures.