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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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QJM, July 1, 2008; 101(7): 567 - 573.
[Abstract] [Full Text] [PDF]


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Eur Heart J SupplHome page
C. Gohlke-Barwolf and J. L. Zamorano
Hot topics in aortic stenosis: Proceedings of a satellite symposium organized by the Scientific Committee of the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) Study in conjunction with the European Association of Echocardiography of the European Society of Cardiology, which was held during the meeting of the European Association of Echocardiography, EUROECHO, Lisbon, 6 December 2007
Eur. Heart J. Suppl., July 1, 2008; 10(suppl_E): E2 - E3.
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MMCTSHome page
F. Maisano, I. Michev, P. Denti, O. Alfieri, and A. Colombo
Transfemoral transcatheter aortic valve implantation using the balloon expandable SAPIEN transcatheter heart valve device
MMCTS, June 26, 2008; 2008(0626): 3087.
[Abstract] [Full Text] [PDF]


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Eur. J. Cardiothorac. Surg.Home page
T. Walther, V. Falk, J. Kempfert, M. A. Borger, J. Fassl, M. W.A. Chu, G. Schuler, and F. W. Mohr
Transapical minimally invasive aortic valve implantation; the initial 50 patients
Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 983 - 988.
[Abstract] [Full Text] [PDF]


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Radiat Prot DosimetryHome page
R. H. Corbett
Ethical issues, justification, referral criteria for budget limited and high-dose procedures
Radiat Prot Dosimetry, June 1, 2008; 130(2): 125 - 132.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
F. Descoutures, D. Himbert, L. Lepage, B. Iung, D. Detaint, D. Tchetche, E. Brochet, Y. Castier, J.-P. Depoix, P. Nataf, et al.
Contemporary surgical or percutaneous management of severe aortic stenosis in the elderly
Eur. Heart J., June 1, 2008; 29(11): 1410 - 1417.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
M. J. Antunes
Percutaneous aortic valve implantation. The demise of classical aortic valve replacement?
Eur. Heart J., June 1, 2008; 29(11): 1339 - 1341.
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Eur Heart JHome page
A. Vahanian, O. Alfieri, N. Al-Attar, M. Antunes, J. Bax, B. Cormier, A. Cribier, P. De Jaegere, G. Fournial, A. P. Kappetein, et al.
Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)
Eur. Heart J., June 1, 2008; 29(11): 1463 - 1470.
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HeartHome page
F Antonini-Canterin, C C Beladan, B A Popescu, C Ginghina, A C Popescu, R Piazza, E Leiballi, B Zingone, and G L Nicolosi
Left atrial remodelling early after mitral valve repair for degenerative mitral regurgitation
Heart, June 1, 2008; 94(6): 759 - 764.
[Abstract] [Full Text] [PDF]


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Eur. J. Cardiothorac. Surg.Home page
E. Lansac, I. Di Centa, F. Raoux, N. A. Attar, C. Acar, T. Joudinaud, and R. Raffoul
A lesional classification to standardize surgical management of aortic insufficiency towards valve repair
Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 872 - 878.
[Abstract] [Full Text] [PDF]


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J Am Coll Cardiol ImgHome page
L. F. Tops, D. A. Wood, V. Delgado, J. D. Schuijf, J. R. Mayo, S. Pasupati, F. P.L. Lamers, E. E. van der Wall, M. J. Schalij, J. G. Webb, et al.
Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement.
J. Am. Coll. Cardiol. Img., May 1, 2008; 1(3): 321 - 330.
[Abstract] [Full Text] [PDF]


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Eur J EchocardiogrHome page
P. Lancellotti, D. Karsera, G. Tumminello, F. Lebois, and L. A. Pierard
Determinants of an abnormal response to exercise in patients with asymptomatic valvular aortic stenosis
Eur J Echocardiogr, May 1, 2008; 9(3): 338 - 343.
[Abstract] [Full Text] [PDF]


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HeartHome page
B. Iung
Management of the elderly patient with aortic stenosis
Heart, April 1, 2008; 94(4): 519 - 524.
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J Am Coll Cardiol IntvHome page
J. G. Webb
Percutaneous Aortic Valve Replacement Will Become a Common Treatment for Aortic Valve Disease
J. Am. Coll. Cardiol. Intv., April 1, 2008; 1(2): 122 - 126.
[Abstract] [Full Text] [PDF]


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CirculationHome page
T. K. Rosengart, T. Feldman, M. A. Borger, T. A. Vassiliades Jr, A. M. Gillinov, K. J. Hoercher, A. Vahanian, R. O. Bonow, and W. O'Neill
Percutaneous and Minimally Invasive Valve Procedures: A Scientific Statement From the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group
Circulation, April 1, 2008; 117(13): 1750 - 1767.
[Abstract] [Full Text] [PDF]


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BMJHome page
R. Ramaraj and V. L Sorrell
Degenerative aortic stenosis
BMJ, March 8, 2008; 336(7643): 550 - 555.
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J Am Coll Cardiol ImgHome page
F. Grigioni, C. Tribouilloy, J. F. Avierinos, A. Barbieri, M. Ferlito, F. Trojette, L. Tafanelli, A. Branzi, C. Szymanski, G. Habib, et al.
Outcomes in mitral regurgitation due to flail leaflets a multicenter European study.
J. Am. Coll. Cardiol. Img., March 1, 2008; 1(2): 133 - 141.
[Abstract] [Full Text] [PDF]



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