Surgical Consult From AHA: Act Earlier in Aortic Stenosis and Tricuspid Regurgitation?

This transcript has been edited for clarity.

Michelle O'Donoghue, MD: Hi. This is Dr Michelle O'Donoghue, reporting for Medscape from day 1 of the AHA Scientific Sessions, which this year are being held virtually. Live on the scene I have Dr Pat O'Gara, who really needs no introduction; he's certainly a world leader on the topic of valvular heart disease. Today's late-breaking session tackled two important trials that are also being published simultaneously. Let's get down to it. Welcome, Pat.

Pat O'Gara, MD: Thanks very much, Michelle. Great to be with you.

AVATAR: Asymptomatic AS

O'Donoghue: The first trial we're going to discuss is AVATAR, which studied a patient population that had asymptomatic aortic stenosis (AS). It has been a conundrum as to how to manage the asymptomatic patient who has severe AS and a normal stress test. Would you like to walk through the study design?

O'Gara:Absolutely. First and foremost, it's important to recognize that this was a multinational study that was conducted largely in Eastern European surgical sites comprising countries such as Poland and Serbia. Second, these are patients, as you pointed out, with asymptomatic severe AS, and mean jet velocity across the aortic valve in these patients was 4.5 m/s. They also had normal left ventricular systolic function, and they had low surgical risk.