The potential to return to activities of daily living after an intervention must be considered. 2.6. The Multidisciplinary Heart Valve Team and Heart Valve Centers Recommendations for the Multidisciplinary Heart Valve Team and Heart Valve Centers COR LOE Recommendations Patients with severe VHD should be evaluated by a Multidisciplinary Heart Valve Team (MDT) when intervention is considered. Consultation with or referral to a Primary or Comprehensive Heart Valve Center is reasonable when treatment options are being discussed for 1) asymptomatic patients with severe VHD, 2) patients who may benefit from valve repair versus valve replacement, or 3) patients with multiple comorbidities for whom valve intervention is considered.1 19 Synopsis The value of the MDT has become increasingly appar- ent as options in the treatment of VHD have broad- ened. Heart Valve Centers, in the context of an inte- grated multi-institutional model of care for patients with VHD, allow optimization of patient outcomes through improved decision-making and matching of patients to providers with appropriate expertise, expe- rience, and resources.12 Primary and Comprehensive Heart Valve Centers are defined by their offerings and expertise in the management of patients with VHD12 (Table 11). Table 9. 