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Heart valve disease: mixed valve disease, multiple valve disease, and others 

Heart valve disease: mixed valve disease, multiple valve disease, and others
Heart valve disease: mixed valve disease, multiple valve disease, and others

Philippe Unger

and Gerald Maurer

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date: 01 April 2020

Multiple and mixed heart valve disease are highly prevalent. Echocardiography is the cornerstone technique for imaging these patients. As with patients with single-valve stenosis or regurgitation, one should aim to evaluate the aetiology, the mechanism(s) of dysfunction, as well as the consequences and the possibility of repair. There are, however, specific issues, which include the followings: (1) the lack of published data; (2) most indices of valvular regurgitation and of stenosis severity have been validated in patients with single-valve/single-lesion disease; and (3) the haemodynamic interactions that may affect the severity and the diagnosis of these lesions. A global assessment of the consequences of the lesions is of the utmost importance in the decision-making process: whereas only severe regurgitation or stenosis is usually considered for surgery by current guidelines in a single-valve lesion, the combination of two or more less-than-severe lesions causing symptoms, left ventricular dysfunction, and/or pulmonary pressure increase may warrant surgery. This chapter focuses on the echocardiographic assessment of these sometimes complex lesions, emphasizing some pitfalls and tips to take into account when managing these patients.

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