Valvular heart disease
Aortic stenosis and regurgitation, mitral regurgitation and stenosis, tricuspid disease and prosthetic valves, with severity thresholds, when to intervene (ESC/EACTS 2025), TAVI versus surgery, anticoagulation and pregnancy.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Calcific aortic stenosis is the commonest valve lesion needing intervention in Australia and rises steeply after 70. Rheumatic disease dominates in Aboriginal and Torres Strait Islander, Māori and Pacific Islander people and in migrants from endemic countries, and presents decades younger. See rheumatic fever and RHD.
- Echo grades severity. Symptoms or LV decompensation (falling LVEF, dilating LV) decide timing.
- Heart Team review (cardiologist, cardiac surgeon, imager) decides between surgery and transcatheter repair or replacement. Medicare-funded TAVI in Australia needs a documented TAVI case conference.
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Sources
- Praz F, Borger MA, Lanz J et al. 2025 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 2025. doi:10.1093/eurheartj/ehaf194European Society of Cardiology and European Association for Cardio-Thoracic Surgery, 2025
- Otto CM, Nishimura RA, Bonow RO et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease. Circulation 2021;143:e72-e227American College of Cardiology and American Heart Association, 2020
- 2021 CSANZ and ANZSCTS position statement on the operator and institutional requirements for a transcatheter aortic valve implantation (TAVI) program in Australia and New Zealand. Heart Lung Circ 2021;30:1811-8AU/NZCardiac Society of Australia and New Zealand and ANZSCTS (Heart, Lung and Circulation), 2021
- Australian guideline for the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (Edition 3.4, October 2026)AU/NZRHDAustralia (Menzies School of Health Research), Edition 3.4, October 2026
- Généreux P, Schwartz A, Oldemeyer JB et al. Transcatheter aortic-valve replacement for asymptomatic severe aortic stenosis (EARLY TAVR). N Engl J Med 2025;392:217-27New England Journal of Medicine, 2025
- Stone GW, Lindenfeld J, Abraham WT et al. Transcatheter mitral-valve repair in patients with heart failure (COAPT). N Engl J Med 2018;379:2307-18New England Journal of Medicine, 2018
- Last updated
- 14 November 2026
What changed
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