New guidance recommends earlier, less-invasive treatment

In Canada, heart valve disease treatment is shaped by two sets of guidelines: those developed by the European Society of Cardiology/ European Association for Cardio-Thoracic Surgery (ESC/EACTS) and those developed by the American College of Cardiology. While the American College of Cardiology guidelines will be updated later this year, the ESC/EACTS guidelines were updated in 2025, and Canadians should understand how these evidence-based recommendations may inform their treatment.

‍Earlier, less-invasive treatment

‍In the past, care often began only after symptoms appeared, but severe heart valve disease can have no symptoms at all. The new ESC/EACTS guidelines call for earlier treatment of asymptomatic patients with aortic stenosis or primary mitral regurgitation.

The recommendations also lowered the age of patients eligible for a transcatheter aortic valve implantation (TAVI) to 70 years or older, down from 75 years.

Women and HVD

Women experience unique challenges in heart valve disease care, from underdiagnosis to longer treatment waiting times. The new guidelines include a section on sex-specific considerations to improve the treatment of women, which include aortic, mitral, and tricuspid valve diseases.

Patient-centered care

The updated guidance continues to encourage patient-centered care with the addition of the "Heart Team" approach, a patient-centered model that brings specialists together to determine a personalized treatment plan, in collaboration with the patient.

"These guidelines will have a significant impact on patient outcomes and ultimately improve the quality of life of Canadian patients," explains Dr. Philippe Pibarot, Director of Cardiology Research at the Quebec Heart and Lung Institute, Laval University.

Overall, the guidelines offer recommendations to provide treatment earlier, with less-invasive options. They highlight the importance of patient education and emphasize that patients should have a clear understanding of their conditions, their treatment options, and their follow-up care.

Read the patient-friendly version, ESC/EACTS Clinical Practice Guidelines for the Management of  Valvular Heart Disease: What Patients  Need to Know. Learn more about the 2025 European Society of Cardiology guidelines for valve disease.