Decision-making in patients with the valvular disease should ideally be carried out by a ‘‘heart team’’ with particular expertise in valvular heart disease (VHD), including cardiologists, cardiac surgeons, imaging specialists, anesthetists and, if needed, other specialists. This ‘‘heart team’’ approach is particularly advisable in the management of high-risk patients and is also important for other subsets, such as asymptomatic patients, where the evaluation of reparability is a key component in decision-making. A comprehensive evaluation of the cardiac and extra-cardiac condition of the patient, constantly checking for consistency between the results of the diagnostic investigation and clinical findings, is necessary at each step of the decision-making process.
Decision-making in high-risk patients is difficult. In the absence of a perfect risk score, scores should be included in, but…
