{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:42:04Z","timestamp":1788432124938,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Doctoral Research Fellowship"},{"name":"NIHR Clinical Lecturer award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Valvular heart disease poses persistent challenges for clinical decision-making, and international guidelines provide essential frameworks for its management. The American College of Cardiology\/American Heart Association last issued a full update in 2020 and an expert consensus on tricuspid regurgitation in 2025. The European Society of Cardiology\/European Association for Cardio-Thoracic Surgery released their updated guidelines in 2025. Although there is broad alignment in principles of intervention, prosthesis choice, and the role of Heart Teams, the European document incorporates substantial new trial evidence. Key areas of divergence include thresholds for earlier intervention in aortic stenosis and regurgitation, expanded recommendations for transcatheter edge-to-edge repair and mitral replacement, formal integration of tricuspid repair and transcatheter therapies, evolving strategies for coronary assessment in transcatheter aortic valve implantation, and sex-specific considerations. This review highlights consistencies, discrepancies, and priorities for future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay summary<\/jats:title>\n                    <jats:p>This review explains the main similarities and differences between the American and European guidelines on how to diagnose and treat heart valve disease.Both guidelines agree on most major principles but differ in areas such as timing of intervention, imaging requirements, and approaches to aortic stenosis, mitral regurgitation, tricuspid regurgitation, and coronary assessment before valve procedures.The European 2025 guidelines include newer evidence and often recommend earlier treatment or wider use of less invasive transcatheter procedures compared with the American 2020 guidance.<\/jats:p>\n                  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Medical School, University of East Anglia , Norwich Research Park, Norwich NR4 7TJ ,","place":["United Kingdom"]},{"name":"Department of Cardiology, Norfolk and Norwich University Hospital , Colney Lane, Norwich NR4 7UY ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1832-0638","authenticated-orcid":false,"given":"Joseph","family":"Zacharias","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust , Whinney Heys Road, Blackpool FY3 8NR ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Ring","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West Suffolk Hospital , Hardwick Lane, Bury St Edmunds IP33 2QZ ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-7752","authenticated-orcid":false,"given":"Vassilios S","family":"Vassiliou","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia , Norwich Research Park, Norwich NR4 7TJ ,","place":["United Kingdom"]},{"name":"Department of Cardiology, Norfolk and Norwich University Hospital , Colney Lane, Norwich NR4 7UY ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"2026020406520580500_zwag015-B1","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1093\/ehjci\/jeae127","article-title":"Prevalence of asymptomatic valvular heart disease in the elderly population: a community-based echocardiographic study","volume":"25","author":"Tsampasian","year":"2024","journal-title":"Eur Heart J Cardiovasc 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