Multiple valve disease - assessment, strategy and intervention.

Patients with multiple valve disease are a frequent and heterogeneous entity whose evaluation and management are challenging. The assessment of the severity requires a cautious integrative evaluation. The indications for intervention are based on global assessment of the consequences of the disease, mainly based on symptoms, pulmonary hypertension, and left ventricular dysfunction. The decision to intervene should also take into account the inherent additional risk. Percutaneous intervention in this population is in its infancy but the future development of transcatheter techniques will be of interest in this high-risk cohort and will offer the possibility of tailored and staged procedures.