Kim HJ, et al. - In 468 asymptomatic patients with preserved left ventricular (LV) function (≥ 50%) and severe aortic stenosis (AS; aortic valve [AV] area ≤ 1.0 cm², peak trans-AV velocity ≥ 4.0 m/s, or mean AV pressure gradient ≥ 40 mmHg), researchers assessed the survival benefits of performing AV replacement (AVR). They performed AVR in 221 patients early (within 3 months; n=130) or during follow-up (n=91); the remainder (n=247) received medical treatment. The effect of AVR on long-term survival outcomes was assessed via time-dependent Cox regression analyses. AS-related symptoms and death were reported in 72 (15.4%) patients and 146 (31.2%) patients, respectively, during a median follow-up of 60.9 months. A significant risk reduction in all-cause death and cardiac death was observed in association with AVR, after adjusting for significant contributors to mortality. In most risk subgroups, AVR offered survival benefits. Before ventricular dysfunction or symptom development, early recruitment for AVR may be warranted.