New ESC/EACTS Guidelines presented at ESC Congress 2025 aim to improve the diagnosis and treatment of patients with valvular heart disease, reflecting robust new evidence that supports broader and more consistent use of newer, less invasive treatment options.
The guidelines were developed by an international panel of experts, co-chaired by Professor Fabien Praz, interventional cardiologist at Bern University Hospital, and Professor Michael Borger, Director of Cardiac Surgery at the University of Leipzig, Germany.
The updated recommendations clarify when minimally invasive techniques, such as transcatheter aortic valve implantation (TAVI) or minimally invasive mitral valve surgery, should be used. They are informed by the latest evidence, including data from large randomised controlled trials.
Highlighting the need for harmonised practice, the experts explain that they are seeing very different clinical practice across Europe, from regions that are far ahead of guideline recommendations to places where patients are missing out on basic treatments. This means that a patient in Germany might receive a different treatment from someone with the same medical needs in the UK, for example.
However, rapidly expanding knowledge from randomised trials now provides valuable insights into how best to treat patients. This helped the multidisciplinary team reach consensus on many issues. It is hoped that these guidelines will give clinicians worldwide the confidence that they are providing the best possible care.
Valvular heart disease occurs when one or more of the heart’s valves do not function properly, leading to symptoms such as breathlessness, dizziness, fatigue, ankle swelling, or chest pain, though some patients remain symptom-free. Aortic stenosis is the most frequently treated form in developed countries, affecting an estimated 9 million people globally. Mitral regurgitation, the most common type overall, affects around 24 million people worldwide. Prevalence increases with age, particularly among patients with other medical conditions.
The 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease provide practical, evidence-based recommendations to support clinical decision-making and emphasise patient-centred care and shared decision-making. They also recommend that patients with complex disease or requiring advanced procedures be referred to high-volume centres with specialist Heart Teams.
Many patients with valvular heart disease are not receiving treatment when they need it. A major goal of this guidance is to reduce undertreatment, especially in elderly patients, which contributes to avoidable healthcare use and shortened lifespan. The goal is to ensure patients receive the best treatment at the right time, in experienced centres when needed, and with equity of care regardless of where they live.
Source: ESC
Image Credit: ESC
