Publication details

Rationale and design of the Aortic Valve replAcemenT versus conservative treatment in Asymptomatic seveRe aortic stenosis (AVATAR trial): A randomized multicenter controlled event-driven trial

Authors	BANOVIC Marko IUNG Bernard BARTUNEK Jozef ASANIN Milika BELESLIN Branko BIOCINA Bojan CASSELMAN Filip COSTA Mark da DEJA Marek GASPAROVIC Hrvoje KALA Petr LABROUSSE Lois LONCAR Zlatibor MARINKOVIC Jelena NEDELJKOVIC Ivana NEDELJKOVIC Milan NEMEC Peter NIKOLIC Serge D. PENCINA Michael PENICKA Martin RISTIC Arsen SHARIF Faidal CAMP Guy Van VANDERHEYDEN Marc WOJAKOWSKI Wojtek PUTNIK Svetozar
Year of publication	2016
Type	Article in Periodical
Magazine / Source	American Heart Journal
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1016/j.ahj.2016.02.001
Field	Cardiovascular diseases incl. cardiosurgery
Keywords	VALVULAR HEART-DISEASE; BEFORE-SYMPTOM-ONSET; HIGH-RISK PATIENTS; NATURAL-HISTORY; CLINICAL-TRIALS; FOLLOW-UP; SURGERY; PATIENT; PROSTHESIS; SURVIVAL
Description	Aortic valve replacement (AVR) therapy is an obvious choice for symptomatic severe aortic stenosis (AS) patients as it improves symptoms, left ventricular function, and survival. The treatment decisions and indication for AVR in asymptomatic patients with severe AS and normal left ventricular ejection fraction are less well established and the subject of ongoing debate. Many efforts have been made to define the best treatment option in asymptomatic AS patients with normal left ventricular ejection fraction. Retrospective and observational data imply that elective AVR for asymptomatic severe AS may lead to improvement in outcomes in comparison to surgery performed after onset of symptoms. The AVATAR trial will aim to assess outcomes among asymptomatic AS patients randomized to either elective early AVR or medical management with vigilant follow-up. In the latter group, AVR would be delayed until either the onset of symptoms or changes in predefined echocardiographic parameters. To the best of the authors' knowledge, it will be the first large prospective, randomized, controlled, multicenter clinical trial that will evaluate the safety and efficacy of elective AVR in this specific group of patients.