ESC Working Group on Valvular Heart Disease Position Paper-heart valve clinics: Organization, structure, and experiences

Patrizio Lancellotti, Raphael Rosenhek, Philippe Pibarot, Bernard Iung, Catherine M. Otto, Pilar Tornos, Erwan Donal, Bernard Prendergast, Julien Magne, Giovanni La Canna, Luc A. Piérard, Gerald Maurer

Research output: Contribution to journalArticlepeer-review


BackgroundWith an increasing prevalence of patients with valvular heart disease (VHD), a dedicated management approach is needed. The challenges encountered are manifold and include appropriate diagnosis and quantification of valve lesion, organization of adequate follow-up, and making the right management decisions, in particular with regard to the timing and choice of interventions. Data from the Euro Heart Survey have shown a substantial discrepancy between guidelines and clinical practice in the field of VHD and many patients are denied surgery despite having clear indications. The concept of heart valve clinics (HVCs) is increasingly recognized as the way to proceed. At the same time, very few centres have developed such expertise, indicating that specific recommendations for the initial development and subsequent operating requirements of an HVC are needed.AimsThe aim of this position paper is to provide insights into the rationale, organization, structure, and expertise needed to establish and operate an HVC. Although the main goal is to improve the clinical management of patients with VHD, the impact of HVCs on education is of particular importance: larger patient volumes foster the required expertise among more senior physicians but are also fundamental for training new cardiologists, medical students, and nurses. Additional benefits arise from research opportunities resulting from such an organized structure and the delivery of standardized care protocols.ConclusionThe growing volume of patients with VHD, their changing characteristics, and the growing technological opportunities of refined diagnosis and treatment in addition to the potential dismal prognosis if overlooked mandate specialized evaluation and care by dedicated physicians working in a specialized environment that is called the HVC.

Original languageEnglish
Pages (from-to)1597-1606
Number of pages10
JournalEuropean Heart Journal
Issue number21
Publication statusPublished - Jun 1 2013


  • Healthcare organization
  • Heart valve clinic
  • Management
  • Valvular heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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