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Not a lot, chop the top off, trim the excess fat off around the top, butterfly it, then trim a little sinew inside the chambers. The fat is really easy to trim off because it's very dense.
I'd give it a 6/10. I've never eaten heart, or at St John's so there's a little guessing about what we were aiming for. We made it into a pea, lettuce and mint salad and on their recommendation put it into a roll, which improved it over the salad on its own.
I saw these in the Mediterranean supermarket near me so we're trying lambs heart, peas and mint from the St John's book tonight