[The future of catheterization in acquired heart valve diseases].

The value of routine catheterization and angiography in the investigation of acquired valvular disease is currently under debate. In many cases, echocardiography provides enough information, even for pre-operative assessment of the heart disease. However, the pre-operative assessment of the valvular disease requires an estimation of the severity of the valvular lesion and a study of left ventricular performance. In older patients, associated coronary artery disease also has to be evaluated. Finally, in patients who have been treated surgically, the disorders related to recurrence of their valvular disease or to the dysfunction of their valvular prosthesis also have to be identified. Each of these aspects has to be considered; this requires a very thorough clinical evaluation of the symptoms and signs and a combination of investigations, consisting of echocardiography, haemodynamic studies and angiography.