The Mitral Valve Heart Team 2.0: Integrating Imaging, Surgery, Transcatheter Therapies and Artificial Intelligence

The management of mitral valve disease is rapidly evolving, driven by advances in multimodality imaging, surgical techniques, transcatheter therapies, and artificial intelligence (AI). In this changing landscape, the traditional Heart Team model should evolve toward a more integrated and dynamic multidisciplinary approach. The “Mitral Valve Heart Team 2.0” may combine detailed anatomical and functional characterization with surgical expertise, transcatheter treatment options, and AI-assisted data integration to support individualized treatment strategies. Advanced imaging increasingly informs not only diagnosis but also procedural planning and patient selection, while AI may improve reproducibility of mitral regurgitation assessment, risk stratification, and phenotypic characterization. However, these technologies should augment rather than replace expert clinical judgment and shared decision-making. This Communication discusses the emerging components of this paradigm and proposes a practical framework in which imaging specialists, surgeons, interventional cardiologists, heart failure specialists, and data-driven tools interact throughout the patient pathway. The objective is not to create a larger Heart Team, but a more integrated one, capable of matching the right patient to the right treatment at the right time.