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Added value of heart valve clinics in the management of asymptomatic aortic stenosis
  1. Bernard Iung1,
  2. Marko Banovic2,3
  1. 1 Cardiology, Bichat -Claude-Bernard Hospital Cardiology Service, Paris, France
  2. 2 University Clinical Center of Serbia, Belgrade, Serbia
  3. 3 Belgrade Medical School, Belgrade, Serbia
  1. Correspondence to Professor Bernard Iung, Cardiology, Bichat - Claude-Bernard Hospital Cardiology Service, 75018 Paris, Île-de-France, France; bernard.iung{at}

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The need for specific organisations of healthcare structures dedicated to the management of patients with valvular heart disease (VHD) emerged in guidelines on VHD in the 2010s with the introduction of the multidisciplinary heart team in the 2012 European Society of Cardiology (ESC)/European Association of CardioThoracic Surgery guidelines and of the heart valve team and heart valve centres in the 2014 American Heart Association/American College of Cardiology guidelines. The heart valve clinic corresponds to an outpatient clinic dedicated to the evaluation and follow-up of patients with VHD. The rationale, objectives and organisation of a heart valve clinic were detailed in a position paper of the ESC working group on valvular disease in 2013.1

A reason supporting the concept of heart valve clinic was the growing complexity of the management of patients with VHD due in particular to the development of multimodality imaging, increased complexity of decision making with the advent of transcatheter interventions, leading to referral of older patients with comorbidities and followed by complex risk–benefit analyses. Another strong incentive to consider heart valve clinics was the demonstration in the 2000s of important gaps between guidelines and practice, particularly with regard to the underuse of surgery in symptomatic patients with severe VHD despite class I indications according to guidelines. The need for heart valve clinics and heart valve centres has been emphasised throughout the last decade, including in the most recent guidelines. This is not surprising, given the extension in the field of transcatheter techniques and the corresponding serial changes in guidelines. As a consequence, decision making for …

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  • Contributors BI and MB drafted and crirically revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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