Rethinking Surgical Timing in Aortic Regurgitation: A Case for Earlier Intervention

Current guidelines for surgical intervention in severe aortic regurgitation may be too conservative, potentially missing the window for optimal outcomes. This editorial highlight growing evidence suggesting that earlier surgical intervention—particularly in patients with LVEF between 50—55%—may prevent adverse events such as cardiogenic shock, even in patients with preserved systolic function. Chronic LV volume overload can mask early dysfunction, delaying critical treatment. The authors advocate for refined risk stratification using advanced imaging and biomarkers, and call for a prospective randomized trial to establish updated, evidence—based surgical thresholds.