Professor Alfieri, what is the future in the surgical treatment of heart disease? What is heart surgery moving towards? What can patients expect to see as treatments in the next five to 10 years?

Yeah, to foresee the future is obviously difficult. But I can see the situation more or less. The idea is that the toolbox of the therapeutic options is going to increase gradually. And treatments are going to be less invasive. And I would say maybe in 10 to 20 years if patients with heart disease could go to have the treatment like today somebody goes to the dentist. Treatment of heart disease takes a very short time, just in one afternoon, for instance. So that is a vision. But I think that probably this is the direction [of heart disease treatment].

And there are more and more medical devices for heart disease treatment.

Exactly! As I told you, the toolbox every year will be more sophisticated. There will be more devices invented. Devices will be designed for just specific situations, and so on. So the treatment will be more and more personalized, more and more individualized. Heart disease treatments will just respond to the individual needs of the individual patient.

So not just precision medicine, but precision surgery is coming to all patients. Exactly! Is there a patient story that you could discuss that perhaps illustrates some of the topics we talked about today?

I think that probably the most important aspect is what we mentioned before. When a patient can have many problems altogether, for instance, typically it is a patient with heart failure. And to be able to identify all the components of heart failure is crucial to have a very good result of treatment. So I can recall patients that have been very impressive for me. Those patients could receive many treatments together in the context of a heart valve center. They had all the pathophysiological components of heart failure solved. I mentioned patients with ischemia, myocardial hibernation, myocardial stunning, arrhythmias, dilatation of the heart ventricle, dyskinesia. All these things can be treated altogether. So I think that this is a very good example of something that can be done today. All these patients are treated by physicians that cooperate effectively within the heart team and within a heart valve center.

It is very important to have multiple abnormalities and symptoms and pathophysiology treated at the same center. Treatment may involve perhaps several procedures, but all problems are addressed in one place.