Iung B, Delgado V, Rosenhek R, et al. - Researchers analyzed the actual management of valvular heart disease (VHD) and compared practice with guidelines in the VHD II survey designed by the EURObservational Research Programme of the European Society of Cardiology (ESC). Participants were prospectively registered across 28 countries and included patients with severe native VHD or previous valvular intervention. In order for indications for intervention to be regarded as concordant, it was required that the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 ESC and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. Among patients with native VHD, intervention was performed and scheduled in 37.0% and in 26.8%, respectively. Findings although revealed good concordance between Class I recommendations and practice in patients with aortic VHD, a requirement to further improve guideline implementation was suggested by the suboptimal figure in mitral VHD and late referral for valvular interventions.