Azeem Latib and Giuseppe Tarantini discuss how transcatheter therapies are increasingly used to treat critically ill patients with severe valvular disease and cardiogenic shock—patients once considered untreatable. They highlight cases ranging from severe AS with ACS to acute papillary muscle rupture and acute severe regurgitation, showing how TAVI, balloon valvuloplasty and mechanical support can stabilise or even definitively treat these high-risk patients. Above all, they stress the need for a true multidisciplinary Heart Team to manage these complex situations and offer life-saving options where none existed before.

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