This post was authored by Xiushui (Mike) Ren, MD, affiliate member of the ACC.

A near equal proportion of cardiologists and cardiothoracic surgeons attended this year’s ACC/AATS 2014 Heart Valve Summit in Chicago, IL from September 18 – 20.

Conference Co-Director Robert O. Bonow, MD, MACC, kicked-off the meeting with an update of the 2014 ACC/American Heart Association guideline for the management of patients with valvular heart disease. For all valves, the guideline committee emphasized using stages to categorize valve disease, analogous to stages of heart failure. Stage A represents patients at risk for valve disease, such as bicuspid aortic valve or mitral valve prolapse; stage B represents patients with mild to moderate valve dysfunction; stage C represents patients with severe asymptomatic valve disease; stage D represents patients with severe symptomatic valve disease.

The rest of day one’s morning session consisted of focused lectures and case presentations on grading mitral regurgitation (MR) severity by William Zoghbi, MD, MACC, exercise testing in MR, and timing of intervention in asymptomatic severe MR by Maurice Enriquez-Sarano, MD, FACC, and David Adams, MD, FACC.

Tricuspid regurgitation (TR) was also discussed considerably, including guideline updates, timing of TR surgery, and TR repair strategies and outcomes.

The remainder of day one consisted of endocarditis management, rheumatic valve disease, and systolic anterior motion of mitral valve after surgery. In particular, data were presented showing benefit of early surgical intervention in endocarditis with associated valve destruction.

Day two of the conference was focused on the aortic valve. Philippe Pibarot, DVM, PhD, FACC, discussed the difficult condition of low flow aortic stenosis. His lecture was followed by presentations of new surgical approaches to bicuspid aortic valve disease, including valve repair and valve-sparing aortic root replacement.

In the afternoon session, there was considerable debate about balloon-expandable versus self-expanding transcatheter aortic valves, as well as bioprosthesis versus mechanical prosthesis. While there was no clear evidence suggesting superiority of transcatheter aortic valve type, the audience favored bioprosthesis, even in young patients.

Day three’s focus was on the ventricle in the setting of valve disease, specifically, when to intervene and when it is too late to intervene. For example, the LV ejection fraction is < 30 percent or when the patient is very frail, it is probably too late to intervene.

Throughout the conference, attendees were actively involved in case presentations by asking questions and sharing their experiences. Overall it was an informative meeting and I’m already looking forward to next year!

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