ESC Congress 2017 Several new recommendations have been added to the guideline. After transcatheter or surgical implantation of a bioprosthetic valve, echocardiography, including measurement of transprosthetic gradients, should be performed within 30 days after valve implantation, 1 year after implantation, and annually thereafter. Also added is the recommendation for INR self-management (with appropriate training and quality control) for patients with a prosthetic heart valve or valve repair receiving antithrombotic therapy. Table 12 summarises new recommendations for the management of prosthetic valve dysfunction. Table 12. New Recommendations for the Management of Prosthetic Valve Dysfunction Recommendations Class Level I C Reoperation is recommended if paravalvular leak is related to endocarditis or causes haemolysis requiring repeated blood transfusions or leading to severe symptoms. I C Transcatheter closure may be considered for paravalvular leaks with clinically significant regurgitation in surgical high-risk patients (Heart Team decision). IIb C Transcatheter valve-in-valve implantation in aortic position should be considered by the Heart Team depending on the risk of reoperation and the type and size of prosthesis. IIa C Anticoagulation using a VKA and/or UFH is recommended in bioprosthetic valve thrombosis before considering reintervention. M E D I C A L In Review P U B L I S H E R S The editors would like to thank the many members of the ESC Congress 2017 presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication UFH, unfractionated heparin; VKA, vitamin K antagonist. Official Peer-Reviewed Highlights From ESC Congress 2017 11