Valvular heart disease is an important public-health problem with significant morbidity and mortality. In Western countries, the prevalence of significant (moderate and severe) valvular heart disease increases significantly with age and peaks up in patients aged 75 years and older (11.7%).1 Despite the decrease in rheumatic valvular heart disease in the last decades, the increased lifespan of the population of in industrialized countries have led to an increase in the prevalence of degenerative valvular heart disease, maintaining the global prevalence of valvular heart disease still high. In addition, the characteristics of patients with significant valvular heart disease has significantly changed, patients being older and with more associated co-morbidities that cumulatively increase the operative risk or may even contraindicate surgical treatment.2
Increasing experience in surgical repair techniques has provided excellent results and outcomes of patients with mitral and aortic valve disease.3-6 Furthermore, during the last decade, advances in percutaneous treatments have provided feasible and safe alternative therapies for patients without surgical options.7, 8 Multimodality imaging, and particularly, 3-dimensional imaging techniques, have improved the visualization and assessment of valvular structures permitting accurate and tailored treatment for each patient (Figure 1). In addition, these imaging techniques have provided novel insights permitting the development of new devices such as sutureless aortic valves or transcatheter devices.
The Department of Cardiology and Thoracic Surgery of the Leiden University Medical Center have regularly collaborated in numerous research projects on valvular heart disease that have resulted in a large number of scientific papers.3-7, 9-18 The Heart Center Leiden is pioneering a line of research that spans from experimental models and basic research that will provide new insight into the pathophysiology of valvular heart diseases to the evaluation of the clinical impact of novel imaging modalities in the decision making of patients with valvular heart disease.