When Silence is Deadly: How New Evidence and AISAP ValvesAI Could Transform Aortic Stenosis Care

Prof. Robert Klempfner, MD
June 19, 2025
Clinician using handheld ultrasound with AI to detect severe aortic stenosis at the point of care

Severe aortic stenosis (AS) is one of the most common yet often overlooked heart valve diseases. It quietly affects about 2.5% of adults in the U.S., and nearly 1 in 10 people over age 75 has moderate or severe valve disease (source).

Alarmingly, about 25% of severe AS cases are asymptomatic when first diagnosed — meaning many patients feel fine until a sudden heart failure crisis strikes.

The risk of undiagnosed severe AS

Traditionally, medicine took a “watch and wait” approach for asymptomatic severe AS. But the landmark EARLY TAVR trial (Généreux et al., NEJM, 2024) has challenged that practice. In this study, 901 patients with severe AS but no symptoms were randomized to receive early transcatheter aortic valve replacement (TAVR) or standard monitoring. The result: early TAVR cut the risk of death, stroke, or unplanned heart-related hospitalizations almost in half (26.8% vs. 45.3%) over nearly four years.

This benefit came mainly from preventing repeat hospital admissions. Importantly, most patients in the conservative group needed valve replacement anyway — usually after their first severe event. Large registry data back this up: untreated asymptomatic patients still have a 5-year risk of major events around 28%, not far behind the 32% seen in symptomatic patients.

Delaying treatment also drives up costs: each preventable heart failure admission can cost thousands, and deferring TAVR adds up to $20,000 per patient over two years.

Yet despite this evidence, timely diagnosis remains a barrier. Many clinics lack dedicated sonographers, echo slots, or specialists to screen all at-risk patients in time.

AISAP ValvesAI VS. Traditional care

This is where AISAP ValvesAI makes a difference. By embedding advanced AI into handheld ultrasound devices, AISAP ValveAI allows any clinician to perform a quick bedside scan and detect severe AS - symptomatic or silent - with expert-level accuracy. This means earlier detection, timely referral, and equitable access for patients in underserved areas who often face the greatest barriers.

Severe AS won’t wait. With clear evidence and smart tools like AISAP ValvesAI, neither should we.

Prof. Robert Klempfner, MD
Prof. Klempfner is the Chief Medical Officer, AISAP, an AI startup revolutionizing bedside ultrasound diagnostics through machine learning. As a Specialist in Cardiology & Internal Medicine, he leads Israel’s largest cardiac rehabilitation center, treating over 850 patients monthly, including post-transplant, LVAD, and post-MI patients. The center also offers a 65-room medical hotel for post-hospital care. ‍ His research focuses on digital health, with 8 ongoing studies in telemedicine and AI-Based decision support systems. He has published over 140 peer-reviewed articles, in top journals.