Change in symptoms in operated and unoperated patients 1 year following evaluation of surgical AVR. Pie charts display change from baseline to follow-up in NYHA and CCS class for operated and unoperated patients who had data on both time points. Change in symptoms in operated and unoperated patients 1 year following evaluation of surgical AVR. Pie charts display change from baseline to follow-up in NYHA and CCS class for operated and unoperated patients who had data on both time points. Improvement or worsening is defined as at least one class change. AVR, aortic valve replacement; CCS, Canadian Cardiovascular Society; NYHA, New York Heart Association. Andreas Auensen et al. Open Heart 2017;4:e000588 ©2017 by British Cardiovascular Society