Executive Summary

Between January 2025 and March 2026, valvular heart disease crossed a strategic threshold.

Not a device revolution. Not a single headline trial. Something more consequential: a fundamental shift from procedural validation to lifetime architectural planning.

For two decades, the ...

  “The scan looked fine. The patient wasn’t.”
— Every clinician who learned this the hard way

This is not another echo tutorial.

You already know the views.
You’ve done the courses.
You can recite PLAX, PSAX, A4C, subcostal in your sleep.

And yet — patients still deteriorate after a “reassur...

Primary (Degenerative) Mitral Regurgitation: The UK MDT Playbook for Timing, Imaging, and Choosing the Right Intervention

There’s a moment every valve MDT recognises.

The patient looks well. They’re active. They’re “asymptomatic.” The echo report says “severe MR,” but the LV ejection fraction is s...

There’s a moment every ICU/ED clinician recognises.

The blood pressure is falling. Lactate is climbing. The ventilator is being dialled up. Everyone is working — yet the patient is still sliding.

And then someone says the most dangerous sentence in critical care:

“We think it’s septic shock.”

Ma...

“Two patients. Both have severe aortic stenosis. Both feel fine. One is told to wait. The other is offered early intervention. Which one wins? And more importantly — how do we decide?”

That’s the paradox at the heart of asymptomatic severe aortic stenosis — a condition that continues to challen...