Current society guidelines only recommend aortic valve replacement for patients with symptomatic severe AS, with SAVR being considered (class IIa, level B) in asymptomatic patients with very severe AS (mean gradient > 60 mmHg, peak velocity > 5 m/s), left ventricular systolic dysfunction, or markedly elevated BNP (3× upper limit of normal) on repeat measures [5]. The gene discussed is NPPB; the disease is aortic stenosis.