Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Dr. Ottavio Alfieri,
PRO: D.Messika-Zeitoun (Paris, France) - Slides, Rebuttal Slides CONTRA: R.Rosenhek (Vienna, Austria) - Slides, Rebuttal Slides Arguments in favour and against early surgery were presented on the basis of the available scientific evidence. Surgery (preferably mitral valve repair) is indicated when some LV ventricular dysfunction is documented (LVEF <60% ; LVESD >45 mm). Furthermore, new onset of atrial fibrillation and elevated systolic pulmonary artery pressure (>50 mmHg at rest; > 60 mmHg at exercise) are good arguments in favour of surgery. The size of the LA has been shown to be an important determinant of the outcome of patients with asymptomatic organic mitral regurgitation, and therefore should play a role in the decision–making. When all the above circumstances are absent, a attentive waiting attitude is reasonable. Generally speaking, a more aggressive approach is justified when there is a high likelihood of durable valve repair at a low risk.
PRO: S.Rahimtoola (Los Angeles, US) - Slides, Rebuttal Slides CONTRA: H.Baumgartner (Muenster, Germany) - Slides, Rebuttal Slides Surgery is advocated when LV dysfunction (LVEF<50%) is present and when patients develop symptoms or a fall in blood pressure below baseline during exercise test. If the surgical risk is not high, aortic valve replacement can be reasonably carried out even in asymptomatic patients under a number of circumstances associated with a negative influence on prognosis: excessive LV hypertrophy (in patients without hypertension), moderate-severe valve calcification, peak velocity >5.5 m/s, peak velocity progression >0.3m/s/year, ventricular arrhythmias, markedly elevated natriuretic peptide level.
Controversies in asymptomatic valvular diseases
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