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European Heart Journal 2003 24(13):1231-1243; doi:10.1016/S0195-668X(03)00201-X
Copyright © 2003 by the European Society of Cardiology.
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A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease

Bernard Iunga,*, Gabriel Baronb, Eric G. Butchartc, François Delahayed, Christa Gohlke-Bärwolfe, Olaf W. Levangf, Pilar Tornosg, Jean-Louis Vanoverscheldeh, Frank Vermeeri, Eric Boersmaj, Philippe Ravaudb and Alec Vahaniana

a Cardiology Department, Bichat Hospital, AP-HP, Paris, France
b Epidemiology, Biostatistic, and Clinical Research Department, Bichat Hospital, AP-HP, Paris, France
c Cardiac Surgery Department, University Hospital, Wales, Cardiff, UK
d Cardiology Department, Hopital Cardiologique, Lyon, France
e Cardiology Department, Heart Centre, Bad Krozingen, Germany
f Cardiac Surgery Department, St. Elizabeth Hospital, Trondheim, Norway
g Cardiology Department, Vall d’Hebron Hospital, Barcelona, Spain
h Division of Cardiology, Catholic University of Louvain, Brussels, Belgium
i Laurentius Ziekenhuis Roermond, Netherlands
j Thoraxcentre, Rotterdam, Netherlands

* Corresponding author: Bernard Iung, MD, Cardiology Department, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France. Tel.: +33-1-40-25-67-60; fax. +33-1-40-25-67-32
E-mail address: bernard.iung{at}bch.ap-hop-paris.fr

Received 9 January 2003; revised 7 March 2003; accepted 12 March 2003

Aims To identify the characteristics, treatment, and outcomes of contemporary patients with valvular heart disease (VHD) in Europe, and to examine adherence to guidelines.

Methods and results The Euro Heart Survey on VHD was conducted from April to July 2001 in 92 centres from 25 countries; it included prospectively 5001 adults with moderate to severe native VHD, infective endocarditis, or previous valve intervention. VHD was native in 71.9% of patients and 28.1% had had a previous intervention. Mean age was 64±14 years. Degenerative aetiologies were the most frequent in aortic VHD and mitral regurgitation while most cases of mitral stenosis were of rheumatic origin.

Coronary angiography was used in 85.2% of patients before intervention. Of the 1269 patients who underwent intervention, prosthetic replacement was performed in 99.0% of aortic VHD, percutaneous dilatation in 33.9% of mitral stenosis, and valve repair in 46.5% of mitral regurgitation; 31.7% of patients had ≥1 associated procedure. Of patients with severe, symptomatic, single VHD, 31.8% did not undergo intervention, most frequently because of comorbidities. In asymptomatic patients, accordance with guidelines ranged between 66.0 and 78.5%. Operative mortality was <5% for single VHD.

Conclusions This survey provides unique contemporary data on characteristics and management of patients with VHD. Adherence to guidelines is globally satisfying as regards investigations and interventions.

Key Words: Valvular heart disease • Echocardiography • Cardiac surgery


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