Understanding the geometry and thus the possibility of repairing the aortic valve (AV) has evolved over time thanks to the integration of historical insights and technological advances. The aortic root geometry has proven to be central to understanding valve function. Today, with modern finite element models and flow studies supported by four-dimensional magnetic resonance imaging, we have provided a better understanding of the importance of the sinuses of Valsalva in blood flow dynamics. Their presence reduces cusp stress, improves repair durability, and promotes the adoption of valve prostheses with incorporated sinuses. Looking to the future, the scientific community must push towards a better fusion of currently available technologies to address AV repair, towards personalizing procedures to fit the unique anatomy of each patient. New technologies, including artificial intelligence, can provide personalized surgical simulations. The goal is to make techniques more standardized, reproducible and accessible, while maintaining flexibility to address anatomical variability. Additionally, new materials and tools are being explored to further improve outcomes.

Hypertension is a major contributor to the development of cardiovascular disease, and effective blood pressure control is a critical intervention for reducing cardiovascular events. While age-adjusted awareness rates among women surpass those of their male counterparts, gender-specific control rates remain suboptimal. A rigorous pharmacological assessment and evidence-based prescription of antihypertensive agents, meticulously aligned with their distinct mechanistic and therapeutic profiles, constitute a cornerstone of clinical practice. This review examines the distinct epidemiological, pathophysiological, and clinical characteristics of hypertension in women, highlighting gender-specific differences across various life stages. Key topics addressed include hormonal influences, risk factors, pregnancy-related hypertensive disorders, menopause-associated hypertension, and sex-specific responses to treatment. The review emphasizes the importance of tailored management strategies and individualized antihypertensive therapy to improve outcomes in women.

Clinical decision-making for individuals undergoing valvular and aortic surgery remains challenging, particularly in young patients facing lifelong risk and repeated interventions. As predictive technologies such as artificial intelligence and advanced statistical modelling evolve, the surgical community must ensure that key foundational elements, namely data governance, including data standardization, and regulation, are firmly in place. Without high-quality, standardized, and ethically governed data, predictive models risk offering misleading guidance rather than meaningful personalization. While data governance ensures the scientific robustness of predictive technologies, shared decision-making (SDM) ensures these innovations remain closely aligned with the lived experiences, values, and preferences of individual patients. This perspective emphasizes that advancing decision-making in aortic surgery requires deliberate investment in building data ecosystems and fostering SDM communication practices, ensuring that innovation is both scientifically sound and truly responsive to patient needs.