Valvular Heart Diseases - Epidemiology and New Treatment Modalities

The valvular heart diseases (VHD) cause a great burden worldwide. They are grouped as primary valve diseases (PVD) if alteration arises on the valve apparatus or secondary if alteration is due to lesions in other structures. Its true prevalence is better stated when echocardiographic screening is performed because the clinical suspicion is inaccurate to detect patients without advanced lesions. The epidemiology of VHD has changed in the last 60 years, with a shift from rheumatic to degenerative disease as the main etiology of PVD in industrialized countries. Patients with severe VHD commonly progress to a clinical state that requires valvular structural intervention to reestablish valve function and improve prognosis. In this manner, interventional cardiology and cardiovascular surgery have experienced a revolution since the beginning of the century, with the outcome of novel technologies for minimally invasive surgery and less invasive approaches. Transcatheter heart valves (THV) are high cost devices conceived for implantation in inoperable patients or patients deemed as high-risk for surgical complications, being their implantation in low risk patients still a matter of debate.