Title

Management of Patients With Valvular Heart Disease

Authoring Organizations

American College of Cardiology

American Heart Association

Endorsing Organizations

American Association for Thoracic Surgery

American Society of Echocardiography

Society for Cardiovascular Angiography and Interventions

Society of Cardiovascular Anesthesiologists

Society of Thoracic Surgeons

Publication Month/Year

December 17, 2020

Last Updated Month/Year

October 2, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

The focus of this guideline is the diagnosis and management of adult patients with valvular heart disease (VHD). A full revision of the original 1998 VHD guideline was made in 2006, and an update was made in 2008. Another full revision was made in 2014, with an update in 2017. There was an additional statement of clarification specifically for surgery for aortic dilation in patients with bicuspid aortic valves (BAV) in 2016. The present guideline will replace the 2014 guideline and 2017 focused update. Some recommendations from the earlier VHD guidelines have been updated as warranted by new evidence or a better understanding of earlier evidence, whereas others that were inaccurate, irrelevant, or overlapping were deleted or modified. Throughout, our goal was to provide the clinician with concise, evidence-based, contemporary recommendations and the supporting documentation to encourage their use. Where applicable, sections were divided into subsections of 1) diagnosis and follow-up, 2) medical therapy, and 3) intervention. The purpose of these subsections is to categorize the Class of Recommendation according to the clinical decision-making pathways that caregivers use in the management of patients with VHD.

Target Patient Population

Patients with valvular heart disease

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management

Diseases/Conditions (MeSH)

D001020 - Aortic Stenosis, Subvalvular, D021921 - Aortic Stenosis, Supravalvular, D008943 - Mitral Valve

Keywords

valvular heart disease, aortic stenosis, tricuspid stenosis, transcatheter aortic valve replacement (TAVR), heart valves, mitral regurgitation, VHD, TAVR

Source Citation

Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A, Toly C. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Feb 2;143(5):e72-e227. doi: 10.1161/CIR.0000000000000923. Epub 2020 Dec 17. Erratum in: Circulation. 2021 Feb 2;143(5):e229. PMID: 33332150.

Supplemental Methodology Resources

Data Supplement

Methodology

Number of Source Documents
286
Literature Search Start Date
January 1, 1990
Literature Search End Date
December 31, 2016
Specialties Involved
Cardiology