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MATTERHORN Multicenter, Randomized, Controlled Study to Assess Mitral Valve Reconstruction for Advanced Insufficiency of Functional or Ischemic Origin trial MHV Mechanical heart valve MITRA-FR Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation trial mPAP Mean pulmonary artery pressure MR Mitral regurgitation MRI Magnetic resonance imaging MS Mitral stenosis M-TEER Mitral transcatheter edge-to-edge repair MV Mitral valve MVA Mitral valve area MVHD Multiple valvular heart disease N No NCS Non-cardiac surgery NOTION Nordic Aortic Valve Intervention trial NT-proBNP N-terminal pro-B-type natriuretic protein NYHA New York Heart Association OAC Oral anticoagulation PAWP Pulmonary artery wedge pressure PCI Percutaneous coronary intervention PET Positron emission tomography PH Pulmonary hypertension PHT Pressure half-time PISA Proximal isovelocity surface area P mean Mean pressure gradient PMC Percutaneous mitral commissurotomy PMR Primary mitral regurgitation POPular TAVI Antiplatelet Therapy for Patients Undergoing Transcatheter Aortic Valve Implantation PPM Prosthesis–patient mismatch PROM Patient-reported outcome measure PVL Paravalvular leak PVR Pulmonary vascular resistance RA Right atrium/right atrial RCT Randomized controlled trial RECOVERY Randomized Comparison of Early Surgery versus Conventional Treatment in Very Severe Aortic Stenosis RESHAPE-HF2 Randomized Investigation of the MitraClip Device in Heart Failure: 2nd Trial in Patients with Clinically Significant Functional Mitral Regurgitation RF Regurgitant fraction RHC Right heart catheterization RHD Rheumatic heart disease RV Right ventricle/right ventricular RVEF Right ventricular ejection fraction RVol Regurgitant volume SAM Systolic anterior movement SAPT Single antiplatelet therapy SAV Surgical aortic valve SAVR Surgical aortic valve replacement SGLT2i Sodium–glucose co-transporter 2 inhibitor SMR Secondary mitral regurgitation SPAP Systolic pulmonary artery pressure STS Society of Thoracic Surgeons STS-PROM Society of Thoracic Surgeons predicted risk of mortality SVD Structural valve deterioration SVi Stroke volume index TAPSE Tricuspid annular plane systolic excursion TAV Transcatheter aortic valve TAVI Transcatheter aortic valve implantation TDI Tissue Doppler imaging TEER Transcatheter edge-to-edge repair THV Transcatheter heart valve TMVI Transcatheter mitral valve implantation TOE Transoesophageal echocardiography TR Tricuspid regurgitation TRILUMINATE Clinical Trial to Evaluate Cardiovascular Outcomes in Patients Treated With the Tricuspid Valve Repair System trial TRISCEND Edwards EVOQUE Transcatheter Tricuspid Valve Replacement: Pivotal Clinical Investigation of Safety and Clinical Efficacy using a Novel Device TS Tricuspid stenosis TTE Transthoracic echocardiography TTR Time in therapeutic range TV Tricuspid valve UFH Unfractionated heparin VCA Vena contracta area VHD Valvular heart disease VKA Vitamin K antagonist Vmax Peak transvalvular velocity VSARR Valve-sparing aortic root replacement VTE Venous thromboembolism VTI Velocity time integral WHO World Health Organisation WU Wood unit Y Yes

1 Preamble

Guidelines evaluate and summarize available evidence with the aim of assisting health professionals in proposing the best diagnostic or therapeutic approach for an individual patient with a given condition. ESC/ EACTS Guidelines are intended for use by health professionals but do not override their individual responsibility to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with the patient or the patient’s caregiver where appropriate and/or necessary. It is also the health professional’s responsibility to verify the rules and regulations applicable in each country to drugs and devices at the time of prescription and to respect the ethical rules of their profession. ESC Guidelines represent the official position of the ESC on a given topic. Guideline topics are selected for updating after annual expert review of new evidence conducted by the ESC Clinical Practice Guidelines (CPG) Committee. ESC Policies and Procedures for formulating and issuing ESC Guidelines can be found on the ESC website (https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ Guidelines-development/Writing-ESC-Guidelines). This guideline updates and replaces the previous version from 2021. This Task Force was selected by the ESC and the EACTS to include professionals Downloaded from academic.oup.com/eurheartj/article/46/44/4635/8234488 by guest on 07 October 2026