December 18, 2020Journal of the American College of Cardiology
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary
Why the study?
This executive summary was developed to provide updated recommendations for clinicians to diagnose and manage valvular heart disease based on new evidence.
Key Points
- The aim is to summarize updated guidelines for diagnosing and managing valvular heart disease based on the latest evidence.
- Conducted literature search from January 1, 2010, to March 1, 2020.
- Included studies and reviews published in English from PubMed, EMBASE, and Cochrane.
- Focused on updates in diagnostic work-up and interventions including surgical and catheter options.
- Updated recommendations include newer diagnostic options for valvular heart disease.
- Recommendations emphasize timing and choice of surgical and catheter interventions.
- Guideline also provides medical therapy recommendations based on recent evidence.
Structured PICO
P
Population
Patients with valvular heart disease
I
Intervention
Diagnostic work-up, timing and choice of surgical and catheter interventions, and medical therapy
The 2020 ACC/AHA guideline provides updated, evidence-based recommendations for the diagnosis and management of valvular heart disease.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Current research and new technology continue to transform the treatment of heart valve disease, as updated lifestyle and medication guidance evolve, and less invasive procedures have replaced traditional surgery for many patients.”
“From a patient's perspective, it would clearly be optimal for SAVR-only centers to facilitate their cardiologists (interventional and noninterventional) to either convene or direct patients to nearby institutions that do have a MDT evaluating patients with aortic valve disease. If a patient is ultimately rendered for SAVR, then they could be directed back to the referring institution.”
GAGorav AilawadiCardiac surgeon, University of Virginia
“As the number of TAVR centers expands, the number of SAVR-only centers is declining. Furthermore, to ensure guidelines are followed, SAVR-only centers will need to partner with local TAVR referral centers to complete the multidisciplinary evaluation for a shared decision-making approach with the patient.”
Implication
Clinicians should apply updated VHD recommendations to diagnosis and intervention decisions; extends 2014 guidelines with evidence on catheter therapies.
Abstract
AIM This executive summary of the valvular heart disease guideline provides recommendations for clinicians to diagnose and manage valvular heart disease as well as supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from January 1, 2010, to March 1, 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, Cochrane, Agency for Healthcare Research and Quality Reports, and other selected database relevant to this guideline. STRUCTURE Many recommendations from the earlier valvular heart disease guidelines have been updated with new evidence and provides newer options for diagnosis and treatment of valvular heart disease. This summary includes only the recommendations from the full guideline which focus on diagnostic work-up, the timing and choice of surgical and catheter interventions, and recommendations for medical therapy. The reader is referred to the full guideline for graphical flow charts, text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in developing these guidelines.
Discussion
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Cite This Study
Otto et al. (2020) conducted a review in Valvular heart disease. Guideline recommendations was evaluated. The 2020 ACC/AHA executive summary provides updated evidence-based recommendations for the diagnosis, surgical and catheter interventions, and medical management of valvular heart disease.