In contrast to the abundance of literature on coronary artery disease available to guide the clinician in his or her management of such disease, large-scale randomized, controlled trials are rare when it comes to valvular heart disease. Much of what is known and practiced in this field is derived from multiple small, often retrospective studies. For this reason, this book is a much-needed synthesis of the available data, with commentary on the strengths and limitations of the studies on which we must base our clinical decisions. The book is edited and largely written by Dr. Catherine Otto, a widely recognized expert on this topic, with additional contributions by cardiac surgeons and a pathologist. This second edition includes additional chapters written by experts on valvular heart disease during pregnancy and in childhood, subjects that are relevant because of the wide age range of patients who are affected by valvular heart disease. The book is comprehensive without being burdensome. It offers a concise exposition of data from large epidemiologic cohorts that give insight into the cause, scope, and natural history of valvular heart disease, and it succinctly summarizes the results of well-referenced therapeutic investigations. The evolving role of magnetic resonance imaging, computed tomography, and positron-emission tomography in the evaluation of the patient with valvular heart disease is addressed in a well-balanced fashion and is an important addition in light of the increasing availability of these imaging methods. Since bedside acquisition of three-dimensional data sets with the use of echocardiography is also possible now, a more detailed discussion of the role of this technique might have been useful.