Advances in noninvasive monitoring, surgical techniques, and guidelines have collectively improved the prognosis of patients with valvular heart disease.
The past 15 years have brought a remarkable improvement in the clinical outcome of patients with valvular heart disease. It is impossible to attribute the change to any single advance in the field. However, it is likely that more effective noninvasive monitoring of ventricular function, improvement in prosthetic valves, advances in valve-reconstruction techniques, and the development of useful guidelines for choosing the proper timing of surgical intervention have all worked in concert to improve prognosis. Moreover, advances in minimally invasive surgical techniques may make valve procedures more easily tolerated by the patient.1 All valvular heart diseases place a hemodynamic burden . . .
Carabello et al. (1997) studied this question.