Preamble ................................................................................................................................................................................... 5
1. Introduction .......................................................................................................................................................................... 9
1.1. Methodology and Evidence Review ............................................................................................................................. 9
1.2. Organization of the Writing Committee ....................................................................................................................... 9
1.3. Document Review and Approval .................................................................................................................................. 9
1.4. Scope of the Guideline ............................................................................................................................................... 10
2. General Principles .............................................................................................................................................................. 11
2.1. Evaluation of the Patient With Suspected VHD ......................................................................................................... 11
2.2. Definitions of Severity of Valve Disease ................................................................................................................... 11
2.3. Diagnostic TestingDiagnosis and Follow-Up: Recommendations ......................................................................... 12
2.4. Basic Principles of Medical Therapy: Recommendations .......................................................................................... 13
2.5. Evaluation of Surgical and Interventional Risk .......................................................................................................... 14
2.6. The Heart Valve Team and Heart Valve Centers of Excellence: Recommendations ................................................. 14
3. Aortic Stenosis: Recommendations .................................................................................................................................... 16
3.1. Stages of Valvular AS ................................................................................................................................................ 16
3.2. Diagnosis and Follow-Up ........................................................................................................................................... 19
3.3. Medical Therapy ......................................................................................................................................................... 19
3.4. Timing of Intervention ................................................................................................................................................ 19
3.5. Choice of Intervention ................................................................................................................................................ 22
4. Aortic Regurgitation: Recommendations ........................................................................................................................... 23
4.1. Stages of Chronic Aortic Regurgitation ...................................................................................................................... 23
4.2. Diagnosis and Follow-Up ........................................................................................................................................... 27
4.3. Medical Therapy ......................................................................................................................................................... 27
4.4. Timing of Intervention ................................................................................................................................................ 27
5. Bicuspid Aortic Valve and Aortopathy: Recommendations .............................................................................................. 29
5.1. Diagnosis and Follow-Up ........................................................................................................................................... 29
5.2. Intervention ................................................................................................................................................................. 29
6. Mitral Stenosis: Recommendations .................................................................................................................................... 29
6.1. Stages of MS ............................................................................................................................................................... 29
6.2. Diagnosis and Follow-Up .................................................