Valvular Heart Disease
Determine valve lesion & severity
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CardiologySurveillance
Valvular Disease Surveillance (ESC/EACTS 2025)
Valvular Disease Surveillance (ESC/EACTS 2025): Valvular Heart Disease → Native or Prosthetic? → Aortic Stenosis → Multimodality Imaging → Ongoing Surve...
Pathway Overview
11 steps
Algorithm Steps
11 total
01Start 02Decision Native or Prosthetic?
03Action Aortic Stenosis
Native valve
- Mild: Echo 2-3 years
- Moderate: Echo 1-2 years
- Severe asymptomatic: Echo 6 months
- Near threshold: 3-6 months
04Action Multimodality Imaging
2025 Update
- 3D Echo standard
- CT for TAVI planning
- MRI if echo suboptimal
- Fluoroscopy for prosthetic leaflet motion
05Outcome Ongoing Surveillance
Per severity & symptoms
06Action Aortic Regurgitation
Native valve
- Mild-Moderate: Echo 2 years
- Severe stable: Echo 1 year
- Near threshold: 3-6 months
- Path rejoins step 04Shared downstream outcome
07Action Mitral Regurgitation
Native valve
- Mild-Mod: Echo 1-2 years
- Severe Primary: Echo 6-12 months
- Secondary: Per HF protocol
08Action Heart Valve Network
ESC/EACTS 2025 Model
- Heart Valve Clinics: Surveillance
- Heart Valve Centres: Intervention
- Referral criteria defined
- Path rejoins step 05Shared downstream outcome
09Action Mitral Stenosis
Native valve
- Mild-Mod: Echo 1-2 years
- Severe: Echo 6-12 months
- Path rejoins step 08Shared downstream outcome
10Action Prosthetic Valves
Baseline + Surveillance
- Baseline echo at 3 months post-op
- Mechanical: Clinical yearly, Echo 1-2y
- Bioprosthetic: Echo annually after year 5
- TAVI: Echo yearly
11Warning New Symptoms
Reassess promptly
- Dyspnea, syncope, chest pain
- Repeat echo urgently
- Consider intervention evaluation
- Path rejoins step 05Shared downstream outcome
Guideline Source
2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Specific indications for intervention not detailed
- Multimodality imaging criteria simplified
- Does not replace heart team assessment
Contraindicated Populations
pediatric
Applicable Regions
EUUS
EU: ESC/EACTS 2025 Heart Valve Clinics + Centres model
US: ACC/AHA similar surveillance intervals
Version 1Next review: 2028-01-01
Next steps
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Related Resources
Frequently Asked Questions
What is the Valvular Disease Surveillance (ESC/EACTS 2025)?
The Valvular Disease Surveillance (ESC/EACTS 2025) is a surveillance clinical algorithm for Cardiology. It provides a structured decision tree to guide clinical decision-making, based on 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease.
What guideline is the Valvular Disease Surveillance (ESC/EACTS 2025) based on?
This algorithm is based on 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease (DOI: 10.1093/eurheartj/ehab395).
What are the limitations of the Valvular Disease Surveillance (ESC/EACTS 2025)?
Known limitations include: Specific indications for intervention not detailed; Multimodality imaging criteria simplified; Does not replace heart team assessment. Individual patient factors may require deviation from these recommendations.
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