Provides updated 2025 European guidelines for the management of valvular heart disease.
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“The most controversial recommendation in the latest guideline is likely the adjustment of the age cutoff for TAVI and SAVR to 70 from 75 years. That certainly is something that's a sensitive subject, especially amongst the cardiac surgery community.”
“The new 2025 ESC/EACTS guidelines for valvular heart disease appear to overstate the role of transcatheter edge-to-edge repair (TEER) in heart failure with functional mitral regurgitation (FMR), relying on the RESHAPE-HF2 trial and MATTERHORN trial results despite significant methodological limitations. By elevating the recommendation of TEER in FMR not needing CABG to a Class I, level of evidence A, the guidelines adopt a position that is, at best, highly questionable and, at worst, an overreach beyond what the available evidence can legitimately support.”
“We know that a lot of patients with valvular heart disease aren't getting the right treatment when they need it. A major aim of this new guidance is to reduce under treatment, especially in the elderly, because this contributes to unnecessary healthcare resource use and shortened lifespan.”
Updates valvular heart disease management now; extends 2021 ESC/EACTS guidance with integrated 2025 evidence.
The European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) Guidelines represent the views of the ESC and the EACTS and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication.The ESC and the EACTS are not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC/EACTS Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies.Health professionals are encouraged to take the ESC/EACTS Guidelines fully into account when exercising their clinical judgement, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC/EACTS Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver.Nor do the ESC/EACTS Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations.It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices prior to making any clinical decision and to check whether a more recent version of this document exists.
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Praz et al. (2025) conducted a review in valvular heart disease. The 2025 ESC/EACTS Guidelines provide updated recommendations for the management of valvular heart disease based on current scientific and medical knowledge.
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