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The new ESC Council on Valvular Heart Disease.

Valvular heart disease (VHD) represents a significant public health and socio-economic burden, sitting among the top three cardiovascular diseases. Valve disease can also cause—or worsen—heart failure, and 5-year survival of untreated aortic stenosis (AS) is worse than that of lung cancer survival. It is against this backdrop that the European Society of Cardiology (ESC) has established a Council on VHD with a goal to deliver multi-disciplinary, patient-oriented research and management, and refine and champion an integrative approach to treatment and care via heart teams, heart valve clinics, and comprehensive heart valve centres. Not only is VHD a growing area of research, it is also an area of increased focus for device manufacturers, suggesting now is a critical moment for the ESC to establish the Council for VHD to take the focus, awareness, diagnosis, and treatment of the condition to a new level. ‘Innovative prostheses and devices that can be implanted percutaneously make VHD the top growth market in cardiology’, noted Professor Luc Pierard, the inaugural chair of the Council. Currently Honorary Professor of Medicine in the University of Liège and consultant in the University Hospital Sart Tilman, Liège, Belgium, he has a specific area of research in the risk stratification of severe asymptomatic AS. With his team, he was the first to establish the role of exercise stress echo in VHD, conduct the first trials in patients with secondary mitral regurgitation and then in asymptomatic severe AS and in primary mitral regurgitation. Prof. Pierard explained that the ESC Council for VHD was formed from the previous Working Group in VHD during the General Assembly of the 2017 ESC Congress in Barcelona. That followed on from almost a year of discussions with the ESC Board. A key motivation for establishing the Council was an aim to promote multi-disciplinary teamwork in the field. Prof. Pierard, who is also Editor-in-Chief of Acta Cardiologica and Senior Associate Editor of the EHJ Cardiovascular Imaging, said: ‘Decision making in difficult cases is based on a Heart Valve Team and procedures should be performed in Centres of Excellence with a Heart Team that includes cardiac surgeons, interventionalists, imaging specialists, heart failure specialists, and others’. A key driver within the Council is the importance of adopting a ‘a patient-oriented and an integrative approach’. From this, the Council is looking to spread the message and goals of tackling VHD across other ESC groups as it endeavours to increase education and research in valve disease. The Council will integrate valvular care education and guidance and as well as reaching out to specialists, also aims to target relevant information for general cardiologists and primary care physicians, as well as patients, to raise awareness to modern diagnosis and treatment. ‘We are the ESC Council of the Heart Team, bringing together healthcare professionals with different and complementary expertise in order to improve the diagnosis and treatment of VHD’, he said.