This unique text covers all aspects of valvular heart disease, including normal valve anatomy and physiology, pathophysiology, modes of investigation, assessment and treatment of specific valve lesions, valve surgery (both medical and surgical aspects), treatment in pregnancy or during non-cardiac surgery, and the devastating complication of infective endocarditis, in an easy-to-read, accessible format.

Valvular heart disease

Aims: To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development. Methods and results: A committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Cardiology representatives met to reach a consensus based on the analysis of the available data obtained with transcatheter aortic valve implantation and their own experience. The evidence suggests that this technique is feasible and provides haemodynamic and clinical improvement for up to 2 years in patients with severe symptomatic aortic stenosis at high risk or with contraindications for surgery. Questions remain mainly concerning safety and long-term durability, which have to be assessed. Surgeons and cardiologists working as a team should select candidates, perform the Procedure, and assess the results. Today, the use of this technique should be restricted to high-risk patients or those with contraindication for surgery. However, this may be extended to lower risk patients if the initial promise holds to be true after careful evaluation. Conclusion: Transcatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aortic stenosis. Totiay, careful evaluation is needed to avoid the risk of uncontrolled diffusion.

Transcatheter Valve Implantation for Patients with Aortic Stenosis : a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

A Randomized Multicenter Trial of Minimally Invasive Rapid Deployment Versus Conventional Full Sternotomy Aortic Valve Replacement

Cardiac computed tomography in current cardiology guidelines

Background Left atrial (LA) mechanics in patients with severe mitral regurgitation (MR) remain largely unexplored. The aim of the present evaluation was to assess the effect of severe MR on LA function, its potential relation with conventional surgical indications, and long-term postoperative survival. Methods Two-dimensional speckle-tracking strain and volumetric indices of LA reservoir, conduit, and contractile function were assessed in 121 patients with severe MR and 70 controls. Patients were divided according to the presence ( n  = 46) or absence ( n  = 75) of one or more guidelines-based criteria for mitral surgery (symptoms, left ventricular ejection fraction ≤ 60%, left ventricular end-systolic diameter ≥ 40 mm, atrial fibrillation, or systolic pulmonary arterial pressure >50 mm Hg). Results In patients with severe MR compared with controls, significant LA reservoir and contractile dysfunction was observed, which was more pronounced in patients with mitral surgery indication ( P P P  = .02), regardless the symptomatic status before surgery. LA reservoir strain, on top of mitral surgery indications, provided incremental predictive value for postoperative survival. Conclusions Impaired LA reservoir strain in patients with severe organic MR relates to long-term survival after mitral valve surgery, independently of and incremental to current guidelines-based indications for mitral surgery.

Left atrial function by two-dimensional speckle-tracking echocardiography in patients with severe organic mitral regurgitation: Association with guidelines-based surgical indication and postoperative (long-term) survival

Authors/Task Force Members: Alec Vahanian (Chairperson) (France)*, Ottavio Alfieri (Chairperson)* (Italy), Felicita Andreotti (Italy), Manuel J. Antunes (Portugal), Gonzalo Barón-Esquivias (Spain), Helmut Baumgartner (Germany), Michael Andrew Borger (Germany), Thierry P. Carrel (Switzerland), Michele De Bonis (Italy), Arturo Evangelista (Spain), Volkmar Falk (Switzerland), Bernard Iung (France), Patrizio Lancellotti (Belgium), Luc Pierard (Belgium), Susanna Price (UK), Hans-Joachim Schäfers (Germany), Gerhard Schuler (Germany), Janina Stepinska (Poland), Karl Swedberg (Sweden), Johanna Takkenberg (The Netherlands), Ulrich Otto Von Oppell (UK), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain), Marian Zembala (Poland)

Force Members AuthorsTask Force Members

Papers

Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the