Document resource
We thank Useini et al for their thoughtful and well-articulated correspondence1 and for their interest in our recent meta-analysis,2 as well as for their appreciation of our work. We take this opportunity to further clarify several important aspects raised in their letter, particularly given the involvement of some of the authors of the meta-analysis in the recently published 2025 ESC/EACTS guidelines on the management of valvular heart disease.3