In this episode, our hosts are joined by Michael Borger and Nikolaos Bonaros to break down the new valvular heart disease guidelines—what's changed, why it matters, and how the decisions were really made. They cut through the headlines to explain the thinking behind key recommendations, from TAVI thresholds and bicuspid valves to atrial functional MR, concomitant ablation, and the push for heart valve centres. Sharp, practical, and grounded in real-world decision-making, this episode gives you the essentials of modern valve therapy—and the questions that still need answering.

How did a simple stitch transform mitral valve repair? In this episode, we spotlight the pioneers of cardiothoracic surgery, Ottavio Alfieri and Francesco Maisano - the minds behind the edge-to-edge repair. They revisit the early 1990s, when mitral repair was complex and inconsistent, and share how the now-famous Alfieri stitch—inspired by a congenital double-orifice valve—offered a simple, reliable solution. From early skepticism to global adoption and the rise of transcatheter therapies like MitraClip, this conversation traces how one elegant idea reshaped mitral valve treatment and continues to influence the future of structural heart therapy.

This episode focuses on long-term mechanical circulatory support and how durable LVAD therapy is shaping contemporary heart failure management. Joined by Gloria Färber and Daniel Zimpfer, we discuss key advances in device technology, the ongoing challenge of driveline complications, and the critical question of patient selection and timing. The conversation explores LVADs as destination therapy or bridge to transplant, managing right ventricular failure, and the role of temporary support. Looking ahead, the episode highlights emerging technologies and why mechanical circulatory support will remain central to advanced cardiac surgery.