Early Versus Deferred Aortic Valve Replacement in Patients With Moderate Aortic Stenosis and Mitral Regurgitation

Who May Qualify: - Age ≥18 years - Moderate native aortic stenosis defined by an aortic valve area (AVA) ≤1.5 cm2 and \>1.0 cm2 and transvalvular mean gradient ≥20 mmHg and \<40 mmHg. - Primary or secondary mitral regurgitation (at least moderate) defined by effective regurgitant orifice area (EROA) ≥20 mm2 or regurgitant volume ≥30 ml - New York Heart Association (NYHA) functional class ≥2 Who Should NOT Join This Trial: - Life expectancy \<1 year irrespective of valvular heart disease - Left ventricular ejection fraction \<30% or LVESD \>70mm - Echocardiographic evidence of severe right ventricular dysfunction - Untreated clinically significant CAD requiring revascularisation - Moderate or severe aortic regurgitation - Severe tricuspid valve disease requiring intervention - Symptomatic patients with severe primary MR who are operable and not high risk - Patients with severe secondary MR who remain symptomatic despite optimal medical therapy and who are judged appropriate for transcatheter edge-to-edge repair or surgery by the Heart Team - Transcatheter or surgical treatment of valvular and/or coronary artery disease within 90 days prior to randomization - COPD with home oxygen therapy - Estimated or measured systolic PAP \>70 mmHg - Stroke within 30 days prior to the randomization - Inability to provide written willing to sign a consent form - Participation in another cardiovascular trial before reaching the primary endpoint. Always talk to your doctor about whether this trial is right for you.