GIGA Cardiovascular Sciences, Heart Valve Clinic, University of Liège Hospital, Liège, Belgium.
Eur Heart J. 2013 Jun;34(21):1597-606. doi: 10.1093/eurheartj/ehs443. Epub 2013 Jan 4.
With an increasing prevalence of patients with valvular heart disease (VHD), a dedicated management approach is needed. The challenges encountered are manifold and include appropriate diagnosis and quantification of valve lesion, organization of adequate follow-up, and making the right management decisions, in particular with regard to the timing and choice of interventions. Data from the Euro Heart Survey have shown a substantial discrepancy between guidelines and clinical practice in the field of VHD and many patients are denied surgery despite having clear indications. The concept of heart valve clinics (HVCs) is increasingly recognized as the way to proceed. At the same time, very few centres have developed such expertise, indicating that specific recommendations for the initial development and subsequent operating requirements of an HVC are needed.
The aim of this position paper is to provide insights into the rationale, organization, structure, and expertise needed to establish and operate an HVC. Although the main goal is to improve the clinical management of patients with VHD, the impact of HVCs on education is of particular importance: larger patient volumes foster the required expertise among more senior physicians but are also fundamental for training new cardiologists, medical students, and nurses. Additional benefits arise from research opportunities resulting from such an organized structure and the delivery of standardized care protocols.
The growing volume of patients with VHD, their changing characteristics, and the growing technological opportunities of refined diagnosis and treatment in addition to the potential dismal prognosis if overlooked mandate specialized evaluation and care by dedicated physicians working in a specialized environment that is called the HVC.
随着瓣膜性心脏病（VHD）患者的患病率不断上升，需要采用专门的管理方法。所面临的挑战多种多样，包括对瓣膜病变进行适当的诊断和定量评估、组织充分的随访以及做出正确的管理决策，特别是在干预的时机和选择方面。来自欧洲心脏调查的数据显示，VHD 领域的指南与临床实践之间存在很大差距，许多有明确适应证的患者仍被拒绝手术。心脏瓣膜诊所（HVC）的概念越来越被认为是一种可行的方法。与此同时，只有极少数中心具备这种专业知识，这表明需要针对 HVC 的初始发展和后续运行要求制定具体建议。
本立场文件旨在深入了解建立和运营 HVC 的基本原理、组织、结构和所需的专业知识。尽管主要目标是改善 VHD 患者的临床管理，但 HVC 对教育的影响尤为重要：更大的患者数量在资深医生中培养了所需的专业知识，同时也为培训新的心脏病专家、医学生和护士奠定了基础。通过这种有组织的结构提供研究机会以及提供标准化的护理方案也会带来额外的好处。
VHD 患者数量不断增加，其特征不断变化，加上精细诊断和治疗的技术机会不断增加，如果忽视这些机会，潜在的预后不佳，这都要求专门的医生在专门的环境中进行专门的评估和护理，这种环境被称为 HVC。
