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Tables of Recommendations

Recommendation Table 1 — Recommendations for the management of chronic coronary syndrome in patients with valvular heart disease (see also Supplementary data online, Evidence Table 1) ...................................................................................................................... 4656 Recommendation Table 2 — Recommendations for the management of atrial fibrillation in patients with native valvular heart disease (see also Supplementary data online, Evidence Tables 2 and 3) ....................................................................................................... 4657 Recommendation Table 3 — Recommendations on indications for intervention in severe aortic regurgitation (see also Supplementary data online, Evidence Tables 4–8) ................................................................... 4662 Recommendation Table 4 — Recommendations on indications for intervention in symptomatic and asymptomatic severe aortic stenosis, and recommended mode of intervention (see also Supplementary data online, Evidence Tables 9–13) ................................................................................... 4670 Recommendation Table 5 — Recommendations on indications for concomitant aortic valve replacement at the time of coronary artery bypass grafting or ascending aorta surgery ................................................ 4671 Recommendation Table 6 — Recommendations on indications for intervention in severe primary mitral regurgitation (see also Supplementary data online, Evidence Tables 14–16) .............................. 4674 Recommendation Table 7 — Recommendations on indications for intervention in secondary mitral regurgitation (see also Supplementary data online, Evidence Tables 17–20) .............................. 4679 Recommendation Table 8 — Recommendations on indications for percutaneous mitral commissurotomy, mitral valve surgery, and transcatheter intervention in clinically severe rheumatic and degenerative mitral stenosis (see also Supplementary data online, Evidence Table 21) ........................................................................................ 4682 Recommendation Table 9 — Recommendations on indications for intervention in tricuspid regurgitation (see also Supplementary data online, Evidence Tables 22 and 23) ....................................................................... 4687 Recommendation Table 10 — Recommendations on indications for intervention in tricuspid stenosis ................................................................... 4688 Recommendation Table 11 — Recommendations on indications for surgery of concomitant left-sided valvular heart disease ..................... 4690 Recommendation Table 12 — Recommendations on indications for intervention in patients with mixed moderate aortic stenosis and moderate aortic regurgitation (see also Supplementary data online, Evidence Table 24) ................................................................................................. 4690 Recommendation Table 13 — Recommendations for prosthetic valve selection ......................................................................................................... 4691 Recommendation Table 14 — Recommendations for the management of antithrombotic therapy in patients with a mechanical heart valve ........................................................................................ 4693 Recommendation Table 15 — Recommendations for the management of antithrombotic therapy in patients with a mechanical heart valve undergoing elective non-cardiac surgery or invasive procedures .............................................................................................. 4694 Recommendation Table 16 — Recommendations for the management of antithrombotic therapy in patients with a biological heart valve or valve repair ................................................................................. 4696 Recommendation Table 17 — Recommendations for the management of prosthetic valve dysfunction (see also Supplementary data online, Evidence Table 25) ....................................... 4700

List of tables

Table 1 Classes of recommendations .......................................................... 4641 Table 2 Levels of evidence ................................................................................ 4641 Table 3 New recommendations .................................................................... 4643 Table 4 Revised recommendations ............................................................... 4645 Table 5 Requirements for a Heart Valve Centre ................................... 4651 Table 6 Complex procedures ideally performed in the most experienced Heart Valve Centres ................................................................. 4651 Table 7 Clinical and echocardiographic criteria predicting outcome improvement in patients with severe ventricular secondary mitral regurgitation undergoing mitral transcatheter edge-to-edge repair 4678 Table 8 Contraindications for percutaneous mitral commissurotomy in rheumatic mitral stenosis ........................................ 4682 Table 9 Echocardiographic pitfalls, robust measures, and complementary multimodality imaging parameters in multiple or mixed valvular heart disease ............................................................................ 4689 Table 10 International normalized ratio targets and therapeutic ranges for patients with a mechanical heart valve .................................. 4693 Table 11 Peri-operative management of antithrombotic treatment in patients with a mechanical heart valve undergoing non-cardiac surgery based on type of procedure and underlying risk .................... 4694 Table 12 Criteria for the diagnosis of moderate or severe aortic and mitral haemodynamic valve deterioration ..................................... 4697 Table 13 ‘What to do’ and ‘what not to do’ ............................................ 4707

List of figures

Figure 1 The Heart Valve Network .............................................................. 4650 Figure 2 Integrative imaging assessment of patients with valvular heart disease ........................................................................................................... 4652 Figure 3 Central illustration. Patient-centred evaluation for treatment of valvular heart disease ............................................................... 4654 Figure 4 Imaging assessment of patients with aortic regurgitation . 4659 Figure 5 Management of patients with aortic regurgitation ............... 4661 Figure 6 Integrative imaging assessment of patients with aortic stenosis ...................................................................................................................... 4664 Figure 7 Management of patients with severe aortic stenosis .......... 4666 Figure 8 Aortic valve treatment options .................................................... 4667 Figure 9 Factors to be considered when selecting the mode of intervention for aortic stenosis ....................................................................... 4669 Figure 10 Echocardiographic assessment of patients with mitral regurgitation ............................................................................................................ 4672 Figure 11 Management of patients with severe primary mitral regurgitation ............................................................................................................ 4673 Figure 12 Most frequently used criteria for the diagnosis of atrial secondary mitral regurgitation ........................................................................ 4676 Figure 13 Treatment of severe secondary mitral regurgitation without concomitant coronary artery disease ......................................... 4677 Figure 14 Management of clinically severe rheumatic mitral stenosis (mitral valve area ≤1.5 cm2) ............................................................................. 4681 Figure 15 Echocardiographic and invasive assessment of tricuspid regurgitation ............................................................................................................ 4684 Figure 16 Stepwise evaluation of patients with tricuspid regurgitation ............................................................................................................ 4685 Figure 17 Management of patients with tricuspid regurgitation ....... 4686 Figure 18 Antithrombotic therapy following mechanical heart valve implantation ......................................................................................................................... 4692 Figure 19 Antithrombotic therapy following biological heart valve implantation or surgical valve repair ............................................................. 4695 Figure 20 Management of left-sided obstructive and non-obstructive mechanical heart valve thrombosis ............................................................... 4699 Figure 21 Management of non-cardiac surgery in patients with severe aortic stenosis .......................................................................................... 4701 Figure 22 The Pregnancy Heart Team model of care .......................... 4702 Downloaded from academic.oup.com/eurheartj/article/46/44/4635/8234488 by guest on 07 October 2026