{"id":8723,"date":"2025-09-25T10:17:13","date_gmt":"2025-09-25T07:17:13","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8723"},"modified":"2025-09-25T10:17:13","modified_gmt":"2025-09-25T07:17:13","slug":"esc-2025-valvular-heart-disease-vhd-guidelines","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/esc-2025-valvular-heart-disease-vhd-guidelines\/","title":{"rendered":"ESC 2025 \u2013 Valvular Heart Disease (VHD) Guidelines"},"content":{"rendered":"
ESC 2025 \u2013 Valvular Heart Disease (VHD) Guidelines<\/div>\n
<\/div>\n
(Medscape, Sept 23, 2025, ESC Congress Madrid). Published in European Heart Journal<\/div>\n
<\/div>\n
1. General Themes<\/span><\/div>\n
\u2022 Stronger focus on transcatheter therapies and less invasive surgery.<\/span><\/div>\n
\u2022 Heart Team emphasized for decision-making.<\/span><\/div>\n
<\/div>\n
2. New Recommendations (Class IIb unless noted):<\/span><\/div>\n
<\/div>\n
A-Aortic Valve Disease:<\/div>\n
\u2022 Aortic Stenosis (AS):<\/span><\/div>\n
\u2022 ESC now supports earlier intervention in selected asymptomatic severe AS if:<\/span><\/div>\n
\u2022 Very severe (Vmax \u2265 5 m\/s or AVA < 0.6 cm\u00b2).<\/span><\/div>\n
\u2022 LVEF < 50% without another cause.<\/span><\/div>\n
\u2022 Abnormal exercise test (hypotension or symptoms).<\/span><\/div>\n
\u2022 Evidence of fibrosis or elevated biomarkers (BNP\/troponin).<\/span><\/div>\n
\u2022 TAVI Age Cut-off:<\/span><\/div>\n
\u2022 2021: \u226575 years.<\/span><\/div>\n
\u2022 2025: lowered to \u226570 years.<\/span><\/div>\n
\u2022 For low-risk younger patients, surgery remains the preferred option.<\/span><\/div>\n
\u2022 Aortic Regurgitation (AR):<\/span><\/div>\n
\u2022 New option: TAVI may be considered in severe symptomatic AR patients deemed inoperable or high surgical risk.<\/span><\/div>\n
<\/div>\n
B-Mitral Regurgitation (MR)<\/div>\n
\u2022 Secondary (functional) MR:<\/span><\/div>\n
\u2022 ESC 2025: TEER (Transcatheter Edge-to-Edge Repair) is now Class IIb for symptomatic patients despite GDMT (including CRT if indicated) who are not surgical candidates.<\/span><\/div>\n
\u2022 ACC\/AHA 2020: TEER carries a stronger Class I recommendation under similar criteria:<\/span><\/div>\n
\u2022 Severe symptomatic MR (NYHA II\u2013IV).<\/span><\/div>\n
\u2022 LVEF 20\u201350%.<\/span><\/div>\n
\u2022 LV dimension not extremely dilated (LVIDd \u2264 70 mm).<\/span><\/div>\n
\u2022 Unsuitable for surgery.<\/span><\/div>\n
* Primary MR:<\/div>\n
\u2022 Earlier surgical intervention even in some asymptomatic cases.<\/span><\/div>\n
\u2022 Minimally invasive mitral surgery at expert centers for severe primary MR.<\/span><\/div>\n
\u2022 Mechanical valves for patients with long life expectancy (Class IIa).<\/span><\/div>\n
<\/div>\n
3. Revisions vs 2021 Guidelines<\/span><\/div>\n
\u2022 Earlier intervention in asymptomatic severe AS & primary MR.<\/span><\/div>\n
\u2022 TAVI age threshold lowered \u2192 from \u226575 yrs \u2192 now \u226570 yrs.<\/span><\/div>\n
\u2022 Tricuspid transcatheter therapy: upgraded to Class IIa, Level A evidence (proven QoL, RV remodeling, reduced HF admissions).<\/span><\/div>\n
\u2022 Heart Team evaluation mandatory in severe TR to decide therapy candidacy.<\/span><\/div>\n
4. Individualized Care<\/span><\/div>\n
\u2022 Emphasis on patient-centered approach: goals, preferences, comorbidities.<\/span><\/div>\n
\u2022 Referral to experienced centers with full spectrum of options (surgical + transcatheter).<\/span><\/div>\n
5. Future Directions & Technology<\/span><\/div>\n
<\/div>\n
6. Comparison with ACC\/AHA (2020 VHD Guidelines)<\/span><\/div>\n
\u2022 ESC 2025 differs in:<\/span><\/div>\n
* TEER for secondary MR \u2192 Class I in ACC\/AHA.<\/div>\n
* TAVI for AR \u2192 upgraded.<\/div>\n
* Multidisciplinary assessment for severe TR.<\/div>\n
* Recognition of asymptomatic severe AS treatment earlier.<\/div>\n
\u2022 ACC\/AHA update is expected soon.<\/span><\/div>\n
<\/div>\n
http:\/\/www.medscape.com\/viewarticle\/updated-esc-guidelines-support-newer-less-invasive-treatment-2025a1000pb1<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

ESC 2025 \u2013 Valvular Heart Disease (VHD) Guidelines (Medscape, Sept 23, 2025, ESC Congress Madrid). Published in European Heart Journal 1. General Themes \u2022 Stronger focus on transcatheter therapies and less invasive surgery. \u2022 Heart Team emphasized for decision-making. 2. New Recommendations (Class IIb unless noted): A-Aortic Valve Disease: \u2022 Aortic Stenosis (AS): \u2022 ESC […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8723","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8723","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8723"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8723\/revisions"}],"predecessor-version":[{"id":8724,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8723\/revisions\/8724"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8723"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8723"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8723"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}