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Updated Guidelines for Valvular Heart Disease

Updated Guidelines for Valvular Heart Disease

According to recent estimates, just less than 3% of Americans have moderate-to-severe valvular heart disease (VHD), a condition that increases in prevalence with age. The disease affects between 4% and 9% of those aged 65 to 75 and 12% to 13% of those aged 75 and older. Many of these patients require surgical or interventional procedures, but even with these treatments, the overall survival rates associated with VHD are lower than expected. The risk of adverse outcomes due to VHD is high because of limited options for restoring normal valve function and because of failures to intervene at the optimal time point in the disease course. A Welcome Update In 2008, the American College of Cardiology (ACC) and American Heart Association (AHA) released an updated guideline for diagnosing and managing adult patients with VHD. In 2014, the ACC/AHA updated these guidelines in an effort to facilitate access to concise, relevant information at the point of care when clinical knowledge is needed the most. “In the past 5 years, we have accumulated new evidence and a better understanding of earlier research surrounding VHD,” explains Paul Sorajja, MD, FACC, FAHA, FSCAI, who was a member of the ACC/AHA writing group that developed the most recent guideline update. “Our goal was to provide clinicians with concise, evidence-based recommendations and the supporting documentation to encourage their use.” Restructured Definitions The 2014 guidelines include restructured definitions of VHD severity into four classifications—at risk, progressive, asymptomatic severe, and symptomatic severe (Table 1). “These categories were created to help clinicians determine the optimal timing of interventions,” Dr. Sorajja says. The stages consider the degree of valve...
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