By Kelly Young
Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM
The American Heart Association and the American College of Cardiology have updated their guidelines for managing valvular heart disease. The new guidance appears in Circulation.
Here are a few of the changes since the 2014 guidelines:
- Antibiotic prophylaxis for certain dental work is reasonable in high-risk patients, such as those with prosthetic cardiac valves or other prosthetic valve repair material.
- Anticoagulation is recommended in those with atrial fibrillation plus a CHA2DS2-VASc score of 2 or more and who have aortic valve disease, tricuspid valve disease, or mitral regurgitation (and a vitamin K antagonist specifically for patients with rheumatic mitral stenosis).
- Transcatheter aortic valve replacement (AVR) is a reasonable alternative to surgical AVR in symptomatic patients with severe aortic stenosis and intermediate surgical risk.
Patients aged 50 to 70 years have a choice of mechanical or bioprosthetic valve prosthesis, following a discussion of the risks and benefits of each.