GUIDELINE TITLE 2017 American Heart Association and American College of Cardiology Focused Update on the Management of Patients With Valvular Heart Disease DEVELOPERS: American Heart Association and American College of Cardiology RELEASE DATE: March 2017 PRIOR VERSIONS: 2014 and 2008 FUNDING SOURCES: American Heart Association and American College of Cardiology TARGET POPULATION: Patients with valvular heart disease MAJOR RECOMMENDATIONS: This synopsis of the 2017 focused update of the 2014 American Heart Association and American College of Cardiology guidelines for patients with valvular heart disease discusses new recommendations regarding the selection of prosthetic valves in patients with valvular heart disease.1 The following are the new recommendations: The choice regarding the type of prosthetic heart valve should be a shared decision-making process that accounts for the patient's values and preferences and includes discussion of the indications for and risks of anticoagulant therapy and the potential need for and risk associated with reintervention (class I; level of evidence [LOE], C-LD [consensus of expert opinion based on clinical experience]). An aortic or mitral mechanical prosthesis is reasonable for patients younger than 50 years who do not have a contraindication to anticoagulation (Class IIa; LOE, B-NR [moderate quality evidence from nonrandomized trials]). For patients between ages 50 and 70 years, it is reasonable to individualize the choice of either a mechanical or bioprosthetic valve prosthesis on the basis of individual patient factors and preferences after full discussion of the tradeoffs involved (class IIa; LOE, B-NR [moderate quality evidence from nonrandomized trials]). The following 2014 recommendation remains current: A bioprosthesis is reasonable for patients older than 70 years (class IIa; LOE, B).
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine