Valvular heart disease 2019

The number of patients suffering from valvular heart diseases is steadily increasing due to the demographic changes and aging of the population. Interventional treatment modalities in particular have gained in importance in recent years. This is especially true for patients with aortic valve stenosis who can benefit from interventional treatment approaches. The number of catheter-based interventions (TAVI) performed in Germany in recent years is higher than the classical surgical aortic valve replacement (SAVR). This is driven not only by convincing results from randomized clinical trials and less invasive approaches but also due to excellent data derived from the mandatory quality assurance. These data could show that the in-hospital mortality was statistically significantly lower for TAVI in comparison to SAVR. The interventional approach has also gained in importance for patients suffering from mitral valve regurgitation secondary to heart failure. The recently presented results of the COAPT trial demonstrated clear superiority of interventional treatment when compared to optimal pharmacotherapy alone. Interventional treatment options for tricuspid valve regurgitation are relatively new. These offer valuable options for many patients for whom a meaningful treatment was so far unavailable, as isolated tricuspid valve surgery is associated with high mortality in this patient group where a high comorbidity is regularly present. This article summarizes the most important new aspects in the field of structural heart diseases