Controversies in valvular heart disease: insights from cardiac imaging

Numerous controversies still exist in the diagnosis and management of valvular heart disease, for example, the benefit of treating moderate aortic stenosis (AS) or asymptomatic, severe AS and the appropriate selection criteria for transcatheter edge-to-edge mitral valve repair. While numerous imaging parameters have been linked to the risk of sudden cardiac death in mitral valve prolapse, their relative merits are unknown and this is a challenging population to risk-stratify. No large, randomized data exist to guide selection of patients for transcatheter repair of tricuspid regurgitation or valve intervention in severe pulmonary regurgitation. Multimodality cardiac imaging provides unique insights into these important questions.