title: The pivotal role of echocardiography in the assessment of multivalvular heart disease.
abstract: Multivalvular heart disease (MHD) accounts for approximately 15% of the patients undergoing valve surgery in the EuroHeart Survey and for 8.6% of all valvular surgical interventions. Most clinical studies on valvular heart disease are focused on single-valve disease and very few data stress the difficulties encountered in the diagnostic assessment and clinical decision making of multiple defects, also concerning the reciprocal hemodynamic influence or the overlap of surgical indications. Many fields related to multiple valve disease are not encountered in the European Guidelines on Valvular Heart Disease (ESC) or the American College of Cardiology/American Heart Association (ACC/AHA). Increasing age and new trends of mixed population have newly aroused interest in multivalvular heart disease in the developed countries, still in need of new clinical insights. According to the high comorbidities of candidates, the appropriate diagnostic framework necessary for the correct diagnosis and best clinical outcome may still be challenging. The paper reviews multivalvular heart disease (except congenital heart disease) from aetiology and background definition to surgical outcome, with special emphasis on echocardiographic assessment and clinical interpretation.
authors.affiliation: Cardiovascular and Thoracic Department, Università Vita-Salute, Milan, Italy. grimaldi.antonio@hsr.it
authors.forename: A
authors.initials: A
authors.lastname: Grimaldi
authors.forename: A C
authors.initials: AC
authors.lastname: Vermi
authors.forename: F
authors.initials: F
authors.lastname: Pappalardo
authors.forename: S
authors.initials: S
authors.lastname: Benussi
authors.forename: A
authors.initials: A
authors.lastname: Fumero
authors.forename: F
authors.initials: F
authors.lastname: Maisano
authors.forename: A
authors.initials: A
authors.lastname: Colombo
authors.forename: G
authors.initials: G
authors.lastname: La Canna
authors.forename: O
authors.initials: O
authors.lastname: Alfieri
mesh_terms: D019049:Developed Countries; D019468:Disease Management; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D006334:Heart Function Tests; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D011157:Population Dynamics; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology; D011878:Radiotherapy / Q000009:adverse effects; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D004280:Dobutamine