Kang DH, Park SJ, Lee SA, et al. - In view the timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial, researchers randomized a sum of 145 asymptomatic patients with very severe aortic stenosis (characterized as an aortic-valve area of ≤ 0.75 cm² with either an aortic jet velocity of ≥ 4.5 m per second or a mean transaortic gradient of ≥ 50 mm Hg) to early surgery or to conservative care according to the recommendations of current guidelines. A composite of death during or within 30 days after surgery or death from cardiovascular causes during the entire follow-up period was considered as a primary end point, whereas death from any cause during follow-up was the secondary end point. The incidence of the composite of operative mortality or death from cardiovascular causes during the follow-up period among asymptomatic patients with very severe aortic stenosis was significantly lower among those who underwent early aortic-valve replacement surgery than among those who received conservative care.