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2017 Update Incorporated - Valvular Heart Disease

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Disclaimer is Guideline attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care practitioners, and providers at all levels. is Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Abbreviations 2D, 2-dimensional; 3D, 3-dimensional; ΔP, pressure gradient; ACE, angiotensin-converting enzyme; AF, atrial fibrillation; aPTT, activated partial thromboplastin time; AR, aortic regurgitation; ARB, angiotensin-receptor blocker; AS, aortic stenosis; ASA, aspirin; AVA, aortic valve area; AVAi, aortic valve area indexed to body surface area; AVR, aortic valve replacement; BID, twice daily; BP, blood pressure; CABG, coronary artery bypass gra; CAD, coronary artery disease; CKD, chronic kidney disease; CMR, cardiac magnetic resonance; CNS, central nervous system; COR, Class of Recommendation; CRT, cardiac resynchronization therapy; CT, computed tomography; CW, continuous wave; DLCO 2 , diffusion capacity for carbon dioxide; DOAC, direct oral anticoagulant; DSE, dobutamine stress echocardiography; ECG, electrocardiogram; EF, ejection fraction; ERO, effective regurgitant orifice; ETT, exercise treadmill test; FEV1, forced expiratory volume in 1 second; GI, gastrointestinal; GDMT, guideline-directed medical therapy; HF, heart failure; ICD, implantable cardioverter-defibrillator; IE, infective endocarditis; INR, international normalized ratio; IV, intravenous; IVC, inferior vena cava; LA, le atrium; LMWH, low-molecular-weight heparin; LOE, Level of Evidence; LV, le ventricular; LVEF, le ventricular ejection fraction; LVEDD, le ventricular end-diastolic dimension; LVESD, le ventricular end-systolic dimension; LVOT, le ventricular outflow tract; MI, myocardial infarction; MR, mitral regurgitation; MS, mitral stenosis; MV, mitral valve; MVA, mitral valve area; MVR, mitral valve replacement; NVE, native valve endocarditis; NYHA, New York Heart Association; PA, pulmonary artery; PASP, pulmonary artery systolic pressure; PCI, percutaneous coronary intervention; PCWP, pulmonary capillary wedge pressure; PHTN, pulmonary hypertension; PMBC, percutaneous mitral balloon commissurotomy; PO, by mouth; PR, pulmonic regurgitation; PROM, predicted risk of mortality; PVE, prosthetic valve endocarditis; QD, once daily; RA, right atrium; RF, regurgitant fraction; RVol, regurgitant volume; RV, right ventricular; RVH, right ventricular hypertrophy; RVOT, right ventricular outflow tract; Rx, therapy; S. aureus, Staphylococcus aureus; SC, subcutaneous; T½, half-life; spp, species; STS, Society of oracic Surgeons; TA, tricuspid annular; TAVR, transcatheter aortic valve replacement; TEE, transesophageal echocardiography; TR, tricuspid regurgitation; TS, tricuspid stenosis; TTE, transthoracic echocardiography/echocardiogram; TV, tricuspid valve; TVR, tricuspid valve replacement; UFH, unfractionated heparin; VHD, valvular heart disease; VKA, vitamin K antagonist; V max , maximal velocity Source Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP III, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM III, omas JD. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiolog y/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:e57–185. Copublished in Circulation 2014;129:e521–e643. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin III JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt III TM, ompson A, 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease, Journal of the American College of Cardiolog y (2017), doi: 10.1016/j. jacc.2017.03.011. Copublished in Circulation (2017), doi: 10.1016/j.jacc.2017.03.0.011 106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at GuidelineCentral.com Copyright © 2017 All rights reserved ACCVHD1782

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