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Ney Carter Borges: Early Surgery vs Conservative Care in Asymptomatic Very Severe Aortic Stenosis
Ney Carter Borges/LinkedIn
Apr 2, 2026, 16:08

Ney Carter Borges: Early Surgery vs Conservative Care in Asymptomatic Very Severe Aortic Stenosis

Ney Carter Borges, Member Cardiologist of Global Physician Association at Cleveland Clinic Florida, shared a post on LinkedIn:

”Early surgery vs conservative care in asymptomatic very severe aortic stenosis (10-year outcomes)

Key findings (Recovery Trial – 10-Year Follow-up)

Population:
Asymptomatic patients with very severe aortic stenosis
(AVA ≤0.75 cm², Vmax ≥4.5 m/s)

Primary Outcome (CV death or operative mortality):

  • Early Surgery: 3%
  • Conservative Care: 24%
  • HR 0.10 (95% CI 0.02–0.43; p=0.002)

All-Cause Mortality:

  • Early Surgery: 15%
  • Conservative Care: 32%
  • HR 0.42 (95% CI 0.21–0.86)

Heart Failure Hospitalization:

  • Early Surgery: 0%
  • Conservative Care: 19%

Number Needed to Treat (10 years):

  • NNT ≈ 6 (CV death)
  • NNT ≈ 7 (all-cause death)

Clinical interpretation

  • Early intervention dramatically reduces cardiovascular mortality
  • Benefit is sustained over 10 years (no curve convergence)
  • Conservative strategy leads to:
  • Delayed surgery
  • Higher HF burden
  • Increased pre-operative risk
  • Key insight: ‘Waiting for symptoms may allow irreversible myocardial damage’

Practice-changing message

In carefully selected asymptomatic patients with very severe AS, early surgical AVR should be strongly considered, especially when:

  • Low surgical risk
  • High transvalvular velocity
  • Evidence of disease progression.”

Ney Carter Borges: Early Surgery vs Conservative Care in Asymptomatic Very Severe Aortic Stenosis

Other posts featuring Net Carter Borges on Hemostasis Today.

aortic stenosis Health Hematology Hemostasis News Hemostasis Today Medicine Ney Carter Borges Surgery thrombosis
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