Chronic Valvular Heart Disease

Valvular heart disease (VHD) refers to a series of disorders that affect the heart valves by altering their correct functioning; they are divided into two main categories: stenosis (defined as a narrowing of the valve orifice) and insufficiency (which causes a lack of coaptation of the valvular leaflets leading to a retrograde blood regurgitation) [1]. VHD encompasses several common cardiovascular conditions that account for 10% to 20% of all cardiac surgical procedures in the United States. The most frequent VHD occurs in the so-called left heart and therefore affects the aortic and mitral valves. With regard to the former, aortic valve stenosis (AVS) represents the most widespread valvulopathy in Western countries, mostly determined by the development of calcifications linked to ageing processes, reaching a prevalence of 3% in the population over 70 years of age [2]; the age of onset of severe AVS stenosis is 50 years for patients with bicuspid aortic valve and 30 years for patients with unicuspid aortic valve. In developing countries, rheumatic disease remains the leading cause of aortic valvulopathy [2].