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Luc A. Pierard, Alec Vahanian, The year in cardiology 2014: valvular heart disease, European Heart Journal, Volume 36, Issue 7, 14 February 2015, Pages 416–420, https://doi.org/10.1093/eurheartj/ehu502
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Preamble
Numerous articles have been published in 2014 regarding valvular heart diseases. Many papers focused on percutaneous interventions: transcatheter aortic valve implantation and percutaneous mitral valve repair. This article presents the most relevant articles published in 2014 in this important clinical setting.
Epidemiology
Valvular heart disease remains frequent but is subject to temporal and spatial epidemiological heterogeneity and this has important consequences on patient management. The predominance of degenerative aetiologies in industrialized countries accounts for the high burden of valve disease in elderly patients with comorbidities. Unfortunately, it is not possible today to accurately estimate the prevalence of chronic secondary mitral regurgitation (MR) from available population-based studies as they do not comprise an analysis of anatomical features and mechanisms of MR. This should be dealt with by running prospective registries with homogenous echocardiographic assessment.1
Guidelines
The recently issued ACC/AHA guidelines in 20142 are largely concordant, with respect to most recommendations, with the 2012 ESC/EACTS guidelines.3 The rare discrepancies and the number of level C recommendations highlight the need for further randomized studies and large registries. Both documents stress the importance of risk assessment and shared decision-making emphasizing the need for an individualized approach.