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European Heart Journal 2003 24(13):1231-1243; doi:10.1016/S0195-668X(03)00201-X
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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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Ann. Thorac. Surg., January 1, 2008; 85(1): 102 - 107.
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T. M. Dewey, D. Brown, W. H. Ryan, M. A. Herbert, S. L. Prince, and M. J. Mack
Reliability of risk algorithms in predicting early and late operative outcomes in high-risk patients undergoing aortic valve replacement
J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 180 - 187.
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T. Feldman and M. B. Leon
Prospects for Percutaneous Valve Therapies
Circulation, December 11, 2007; 116(24): 2866 - 2877.
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J. Ibanez, M. Riera, J. I. Saez de Ibarra, A. Carrillo, R. Fernandez, J. Herrero, M. Fiol, and O. Bonnin
Effect of preoperative mild renal dysfunction on mortality and morbidity following valve cardiac surgery
Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 748 - 752.
[Abstract] [Full Text] [PDF]

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D. S. Bach, N. Cimino, and G. M. Deeb
Unoperated Patients With Severe Aortic Stenosis
J. Am. Coll. Cardiol., November 13, 2007; 50(20): 2018 - 2019.
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B. Marcheix, Y. Lamarche, C. Berry, A. Asgar, J.-C. Laborde, A. Basmadjian, A. Ducharme, A. Denault, R. Bonan, and R. Cartier
Surgical aspects of endovascular retrograde implantation of the aortic CoreValve bioprosthesis in high-risk older patients with severe symptomatic aortic stenosis.
J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1150 - 1156.
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J.-L. Monin, M. Monchi, M. E.W. Kirsch, H. Petit-Eisenmann, S. Baleynaud, C. Chauvel, D. Metz, C. Adams, J.-P. Quere, P. Gueret, et al.
Low-gradient aortic stenosis: impact of prosthesis-patient mismatch on survival
Eur. Heart J., November 1, 2007; 28(21): 2620 - 2626.
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M. Scorsin, N. Al-Attar, and A. Lessana
A novel technique of utilizing artificial chordae for repair of mitral valve prolapse.
J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 1072 - 1073.
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S. H. Goldbarg, S. Elmariah, M. A. Miller, and V. Fuster
Insights Into Degenerative Aortic Valve Disease
J. Am. Coll. Cardiol., September 25, 2007; 50(13): 1205 - 1213.
[Abstract] [Full Text] [PDF]

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J.-P. Laissy, D. Messika-Zeitoun, J.-M. Serfaty, V. Sebban, E. Schouman-Claeys, B. Iung, and A. Vahanian
Comprehensive evaluation of preoperative patients with aortic valve stenosis: usefulness of cardiac multidetector computed tomography
Heart, September 1, 2007; 93(9): 1121 - 1125.
[Abstract] [Full Text] [PDF]

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J. G. Webb, S. Pasupati, K. Humphries, C. Thompson, L. Altwegg, R. Moss, A. Sinhal, R. G. Carere, B. Munt, D. Ricci, et al.
Percutaneous Transarterial Aortic Valve Replacement in Selected High-Risk Patients With Aortic Stenosis
Circulation, August 14, 2007; 116(7): 755 - 763.
[Abstract] [Full Text] [PDF]

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E. Grube, L. Buellesfeld, U. Gerckens, R. Mueller, M. Menichelli, T. Schmidt, J. C. Laborde, T. Felderhoff, S. Iversen, B. Sauren, et al.
Response to Letter Regarding Article, "Percutaneous Implantation of the CoreValve Self-Expanding Valve Prosthesis in High-Risk Patients With Aortic Valve Disease: The Siegburg First-in-Man Study"
Circulation, June 5, 2007; 115(22): e613 - e613.
[Full Text] [PDF]

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L. A Pierard and P. Lancellotti
Stress testing in valve disease
Heart, June 1, 2007; 93(6): 766 - 772.
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M. Mirabel, B. Iung, G. Baron, D. Messika-Zeitoun, D. Detaint, J.-L. Vanoverschelde, E. G. Butchart, P. Ravaud, and A. Vahanian
What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?
Eur. Heart J., June 1, 2007; 28(11): 1358 - 1365.
[Abstract] [Full Text] [PDF]

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R. Lee and T. H. Marwick
Assessment of subclinical left ventricular dysfunction in asymptomatic mitral regurgitation
Eur J Echocardiogr, June 1, 2007; 8(3): 175 - 184.
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L. Coats and P. Bonhoeffer
NEW PERCUTANEOUS TREATMENTS FOR VALVE DISEASE
Heart, May 1, 2007; 93(5): 639 - 644.
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P. Kolh, A. Kerzmann, C. Honore, L. Comte, and R. Limet
Aortic valve surgery in octogenarians: predictive factors for operative and long-term results
Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 600 - 606.
[Abstract] [Full Text] [PDF]

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E. Lansac, I. Di Centa, F. Raoux, R. Raffoul, N. Al Attar, A. Rama, C. Acar, and P. Nataf
Aortic annuloplasty: towards a standardized approach of conservative aortic valve surgery
MMCTS, March 29, 2007; 2007(0329): 1958.
[Abstract] [Full Text] [PDF]


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