But first, some data about survival and death in moderate AS. I would like to start by paraphrasing one of the most passionate researchers in the field of aortic stenosis, C. Otto (2): "even mild disease is important" (referring of course at the outcomes of patients with mild AS). Similarly, people with moderate AS/ aortic sclerosis, not even mentioning moderate to severe AS (3) have an increased death rate in comparison to age-matched healthy population. The same author reported in 1999 the results of a prospective study (4) with a follow-up (FU) at 5 years and she observed a cardiac death rate of 6.1% in general population (normal aortic valves), 10.1% in patients with aortic sclerosis and 19.6% in patients with AS. In 2004 Rosenhek et al. (5) found a cardiac death rate of 8.7% in a population with mean age of 67 years, with moderate AS at the initial examination. Even though the largest study (6) evaluating medical treatment in moderate AS reported a cardiac death rate of 6.0% (similar to general population), we consider this study not eloquent because there was a super-selected population enrolled (investigators ruled out the most important progression factors of AS: exclusion criteria included history of coronary artery disease (CAD), stroke and diabetes mellitus (DM)).