OBJECTIVES: The management of asymptomatic @entity1 with severe @entity337 remains controversial. Accordingly, the aim of the present study was to assess the long-term outcomes and incidence of @entity299 among asymptomatic @entity1 with severe @entity337 who underwent operation early, in the absence of any class I or class IIa guideline triggers, or were managed conservatively and eventually underwent operation whenever these triggers appeared. METHODS: A total of 160 consecutive asymptomatic @entity1 (50      17  years) with severe @entity337 were prospectively followed up for a median of 7.2  years. Overall and cardiovascular survivals and the need for repeat @entity337 surgery were evaluated in an "early surgery" group (n  =  91) and a "conservatively managed" group (n  =  69). RESULTS: Ten-year overall (91%      4% vs 89%      5%, P  =  .87) and cardiovascular (96%      2% vs 96%      3%, P  =  .79) survivals were similar among the early surgery and conservatively managed groups. Conservatively managed @entity1 were further sub-stratified according to the regularity and quality of their follow-up. @entity1 who were regularly followed up by a certified cardiologist had a better 10-year overall survival than @entity1 undergoing no or a looser follow-up (95%      5% vs 79%      10%, P  =  .045). Multivariate Cox proportional hazards analysis identified age (P  =  .003) and male gender (P  =  .024) as independent predictors of survival. Early surgical management was not a predictor of outcome (P  =  .45). CONCLUSIONS: Our results show that the outcome of asymptomatic @entity1 with severe @entity337 is not different between an early surgical and a more conservative strategy, provided that the conservatively managed @entity1 are regularly followed up and timely referred to surgery as soon as operative triggers develop. This suggests that surgery should not be recommended in @entity1 with @entity337 who do not meet current guidelines for intervention.

Early surgical intervention versus watchful waiting and outcomes for asymptomatic severe XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'Patients'] @entity337 :: ('MESH:D001022', 'Disease') :: ['aortic regurgitation'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac complications']
@entity337 :: (MESH:D001022,Disease) :: ['aortic regurgitation']
