[Comment] Lifetime management of heart valve disease—treat it early and treat it right, first time

Heart valve disease is an important cause of death and disability, and its incidence is increasing due to the ageing population globally.1 There is wide geographical variation in the cause of valvular disease, with rheumatic disease being a more prevalent cause in low-income and middle-income countries and degenerative diseases being a more prevalent cause in high-income countries. Presently, by the time most people are diagnosed and referred, the effect of treatment is often considered palliative rather than curative,2 and survival without cardiac interventions for patients with severe symptoms is lower than for some malignant conditions (eg, prostate, bladder, and colorectal cancer).