European Heart Journal Advance Access published online on January 26, 2007
European Heart Journal, doi:10.1093/eurheartj/ehl428
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Guidelines on the management of valvular heart disease
The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Authors/Task Force Members,
Paris, ( France)
Vienna ( Austria)
Leiden ( The Netherlands)
Cardiff ( UK)
Leiden ( The Netherlands)
Athens ( Greece)
Erlangen ( Germany)
Norwich ( UK)
Paris ( France)
Lodz ( Poland)
Paris ( France)
Barcelona ( Spain)
Milan ( Italy)
Leiden ( The Netherlands)
ESC Committee for Practice Guidelines (CPG),
Italy
France
Poland
UK
France
The Netherlands
Norway
Greece
France
Italy
Portugal
Germany
Spain
Spain
Document Reviewers,
Spain
Italy
Portugal
Spain
Germany
France
UK
USA
Belgium
Spain
UK
Austria
Portugal
Spain
* Corresponding author. Chairperson: Alec Vahanian, Service de Cardiologie, Hôpital Bichat AP-HP, 46 rue Henri Huchard, 75018 Paris, France. Tel: +33 1 40 25 67 60; fax: +33 1 40 25 67 32. E-mail address: alec.vahanian@bch.aphp.fr
| The first 150 words of the full text of this article appear below. |
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Preamble |
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Guidelines and Expert Consensus Documents aim to present management recommendations based on all of the relevant evidence on a particular subject in order to help physicians select the best possible management strategies for the individual patient suffering from a specific condition, taking into account the impact on outcome and also the risk–benefit ratio of a particular diagnostic or therapeutic procedure. Numerous studies have demonstrated that patient outcomes improve when guideline recommendations, based on the rigorous assessment of evidence-based research, are applied in clinical practice.
A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) and also by other organizations or related societies. The profusion of documents can put at stake the authority and credibility of guidelines, particularly if discrepancies appear between different documents on the same issue, as this can lead to confusion in the minds of physicians.
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Introduction |
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Why do we need guidelines on valvular heart disease?
Contents of these guidelines
How to use these guidelines
Method of review
Definition of levels of recommendation
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General comments |
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Patient evaluation
Clinical evaluation
Echocardiography
Fluoroscopy
Radionuclide angiography
Stress testing
Exercise ECG
Exercise echocardiography
Other stress tests
Other non-invasive imaging techniques
Computed tomography
Magnetic resonance imaging
Biomarkers
Coronary angiography
Cardiac catheterization
Assessment of comorbidity
Endocarditis prophylaxis
Risk stratification
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Aortic regurgitation |
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Introduction
Evaluation
Natural history
Results of surgery
Indications for surgery
Medical therapy
Serial testing
Special patient populations
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Aortic stenosis |
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Introduction
Evaluation
Natural history
Results of intervention
Indications for surgery
Indications for balloon valvuloplasty
Medical therapy
Serial testing
Special patient populations
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Mitral regurgitation |
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Organic mitral regurgitation
Evaluation
Natural history
Results of surgery
Indications for intervention
Medical therapy
Serial testing
Ischaemic mitral regurgitation
Evaluation
Natural history
Results of surgery
Indications for surgery
Functional mitral regurgitation
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Mitral stenosis |
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Introduction
Evaluation
Natural history
Results of intervention
Percutaneous balloon commissurotomy
Surgery
Conservative surgery
Valve replacement
Indications for intervention
Medical therapy
Serial testing
Special patient populations
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Tricuspid disease |
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Tricuspid stenosis
Evaluation
Surgery
Percutaneous intervention
Indications for intervention
Medical therapy
Tricuspid regurgitation
Evaluation
Natural history
Results of surgery
Indications for surgery
Medical therapy
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Combined and multiple valve diseases |
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Prosthetic valves |
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Choice of prosthetic valve
Management after valve replacement
Baseline assessment and modalities of follow-up
Antithrombotic management
General management
Target INR
Antiplatelet drugs
Interruption of anticoagulant therapy
Management of valve thrombosis
Management of thrombo-embolism
Management of haemolysis and paravalvular leak
Management of bioprosthetic failure
Heart failure
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Management during non-cardiac surgery |
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Clinical predictors of increased perioperative cardiovascular risk
Preoperative clinical evaluation
Specific valve lesions
Aortic stenosis
Mitral stenosis
Aortic regurgitation and mitral regurgitation
Prosthetic valves
Endocarditis prophylaxis
Perioperative monitoring
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Management during pregnancy |
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Cardiac risk of pregnancy
Evaluation of the pregnant patient with HVD
Specific risks related to pregnancy
Native valve disease
Patients with prosthetic valves
Treatment
Aims
Methods
Management strategy
Delivery
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D. Detaint, J. Maalouf, C. Tribouilloy, D. W. Mahoney, H. V. Schaff, A. J. Tajik, and M. Enriquez-Sarano Congestive heart failure complicating aortic regurgitation with medical and surgical management: a prospective study of traditional and quantitative echocardiographic markers. J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1549 - 1557. [Abstract] [Full Text] [PDF]
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C. Tribouilloy and F. Levy Assessment and management of low-gradient, low ejection fraction aortic stenosis Heart, December 1, 2008; 94(12): 1526 - 1527. [Full Text] [PDF]
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W. H. Gaasch and T. E. Meyer Left Ventricular Response to Mitral Regurgitation: Implications for Management Circulation, November 25, 2008; 118(22): 2298 - 2303. [Full Text] [PDF]
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M. J. Antunes Guidelines in real life. Why are they not always enforced? Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 935 - 936. [Full Text] [PDF]
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D. Detaint, B. Iung, L. Lepage, D. Messika-Zeitoun, G. Baron, P. Tornos, C. Gohlke-Barwolf, and A. Vahanian Management of asymptomatic patients with severe non-ischaemic mitral regurgitation. Are practices consistent with guidelines? Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 937 - 942. [Abstract] [Full Text] [PDF]
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P. Lancellotti, T. Marwick, and L. A Pierard How to manage ischaemic mitral regurgitation Heart, November 1, 2008; 94(11): 1497 - 1502. [Full Text] [PDF]
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J. P. Dal-Bianco, B. K. Khandheria, F. Mookadam, F. Gentile, and P. P. Sengupta Management of Asymptomatic Severe Aortic Stenosis J. Am. Coll. Cardiol., October 14, 2008; 52(16): 1279 - 1292. [Abstract] [Full Text] [PDF]
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Authors/Task Force Members, K. Dickstein, A. Cohen-Solal, G. Filippatos, J. J.V. McMurray, P. Ponikowski, P. A. Poole-Wilson, A. Stromberg, D. J. van Veldhuisen, D. Atar, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur. Heart J., October 1, 2008; 29(19): 2388 - 2442. [Full Text] [PDF]
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 A. B. Rossebo, T. R. Pedersen, K. Boman, P. Brudi, J. B. Chambers, K. Egstrup, E. Gerdts, C. Gohlke-Barwolf, I. Holme, Y. A. Kesaniemi, et al. Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis N. Engl. J. Med., September 25, 2008; 359(13): 1343 - 1356. [Abstract] [Full Text] [PDF]
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R. A.H. Stewart, O. C. Raffel, A. J. Kerr, R. Gabriel, I. Zeng, A. A. Young, and B. R. Cowan Pilot Study to Assess the Influence of {beta}-Blockade on Mitral Regurgitant Volume and Left Ventricular Work in Degenerative Mitral Valve Disease Circulation, September 2, 2008; 118(10): 1041 - 1046. [Abstract] [Full Text] [PDF]
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A. Vahanian, O. R. Alfieri, N. Al-Attar, M. J. Antunes, J. Bax, B. Cormier, A. Cribier, P. De Jaegere, G. Fournial, A. P. Kappetein, et al. Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 1 - 8. [Abstract] [Full Text] [PDF]
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