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2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease (VHD) [1][2]
2017 ESC/EACTS Guidelines for the management of valvular heart disease [3]
2017 ESC/EACTS Guidelines for the management of valvular heart disease
2017 ESC/EACTS Guidelines for the management of valvular heart disease
2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease (VHD)
2017 ESC/EACTS Guidelines for the management of valvular heart disease
2017 ESC/EACTS Guidelines for the management of valvular heart disease
2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease (VHD)
2017 ESC/EACTS Guidelines for the management of valvular heart disease [3]
Management of Coronary Artery Disease (CAD) in patients with Valvular Heart Disease (VHD)
| Recommendations | Class | Level |
|---|---|---|
| Diagnosis of Coronary Artery Disease | ||
| Coronary angiography is recommended before valve surgery in patients with severe VHD and any of the following:
• history of cardiovascular disease • suspected myocardial ischaemiad • LV systolic dysfunction • in men >40 years of age and postmenopausal women • one or more cardiovascular risk factors. |
I | C |
| Coronary angiography is recommended in the evaluation of moderate to severe secondary mitral regurgitation. | I | C |
| CT angiography should be considered as an alternative to coronary angiography before valve surgery in patients with severe VHD and low probability of CAD or in whom conven- tional coronary angiography is technically not feasible or associated with a high risk. | II | A |
| CT angiography should be considered as an alternative to coronary angiography before valve surgery in patients with severe VHD and low probability of CAD or in whom conven- tional coronary angiography is technically not feasible or associated with a high risk. | IIa | C |
| Indications for Myocardial Revascularization | ||
| CABG is recommended in patients with a primary indication for aortic/mitral valve surgery and coronary artery diameter stenosis ≥70% | I | C |
| CABG should be considered in patients with a primary indication for aortic/mitral valve surgery and coronary artery diameter stenosis ≥50–70%. | IIa | C |
| PCI should be considered in patients with a primary indication to undergo TAVI and coronary artery diameter stenosis >70% in proximal segments. | IIa | C |
| PCI should be considered in patients with a primary indication to undergo transcatheter mitral valve interventions and coronary artery diameter stenosis >70% in proximal segments. | IIa | C |
| CABG = coronary artery bypass grafting; CAD = coronary artery disease; CT = computed tomography; LV = left ventricular; MSCT = multislice computed tomography; PCI = percutaneous coronary intervention; TAVI = transcatheter aortic valve implantation; VHD = valvular heart disease. | ||
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM, Thompson A (2017). "2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Circulation. 135 (25): e1159–e1195. doi:10.1161/CIR.0000000000000503. PMID 28298458.
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM, Thompson A (2017). "2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J. Am. Coll. Cardiol. 70 (2): 252–289. doi:10.1016/j.jacc.2017.03.011. PMID 28315732.
- ↑ 3.0 3.1 Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Muñoz DR, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL (2017). "2017 ESC/EACTS Guidelines for the management of valvular heart disease". Eur. Heart J. 38 (36): 2739–2791. doi:10.1093/eurheartj/ehx391. PMID 28886619.