The Heart Valve Centre

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Abstract

Heart valve centers of excellence include a specialist valve clinic and multidisciplinary teams delivering interventions. The valve clinic assesses new outpatients and monitors those with moderate and severe valve disease to determine the optimum timing of surgery. It also supervises inpatient care for valve disease including infective endocarditis. The minimum interventions offered are: replacement of valves in all 4 positions; mitral valve repair; tricuspid annuloplasty and repair; ancillary procedures, left atrial appendage closure, AF ablation; percutaneous balloon mitral valvotomy; TAVI; percutaneous repair of paraprosthetic regurgitation; aortic replacement. The core of the multidisciplinary teams is a cardiologist specialising in valve disease, an echocardiographer, an interventional cardiologist and a surgeon. There must be expert imaging including CMR and CT and a variety of cardiac and non-cardiac associated specialists including electrophysiologists, intensivists, spinal specialists and geneticists. This chapter discusses consensus views on standards for the components of the center of excellence including individual surgeon and center volumes. Good results are usually associated with high individual and center volumes, but this relationship is complex. Results of surgery should be published by center and should include rates of residual regurgitation rates for mitral repairs and reoperation rates matched to the preoperative pathology and risk. The center should be involved with methods of improving detection of valve disease in the community and national programmes of training and audit.

Keywords

Heart valve disease Multidisciplinary teams Heart valve center of excellence Heart valve clinic 
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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cardiothoracic Centre, Guy’s and St Thomas’ HospitalsLondonUK
  2. 2.Department of CardiologyUniversity of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart TilmanLiègeBelgium
  3. 3.GVM Care and Research, E.S. Health Science FoundationLugoItaly

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