Heart scarring may begin before symptoms — could early valve replacement stop it?

Severe aortic stenosis narrows the heart's aortic valve, and current guidelines recommend waiting until symptoms appear before replacing it. But MRI scans show that up to half of patients already have heart scarring by then, which doesn't fully reverse after surgery. This study will use MRI to compare heart scarring in patients randomly assigned to early valve replacement versus watchful waiting, to see if earlier intervention leads to less scarring and better quality of life.