What is new in the 2006 ACC/AHA guidelines on valvular heart disease?
- First Online:
- 69 Downloads
In June 2006, the American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Valvular Heart disease were published. Although many recommendations were unchanged from the 1998 guidelines, several new suggestions bear comment. The new guidelines favor a more aggressive approach to most valve lesions. For patients with low-gradient, low ejection fraction aortic stenosis, detecting inotropic reserve to help risk stratify such patients is now recommended. In the field of aortic regurgitation, the use of vasodilators to forestall surgery has been called into doubt by newer data; thus, recommendations for vasodilator use have been softened. For patients with mitral regurgitation, earlier surgery and mitral repair are highlighted. The new guidelines also reflect a growing trend toward the use of biological valves instead of mechanical prostheses. This 150-page document with more than 1000 references should be useful in guiding practice for these often complex patients. This article summarizes some of the more salient changes in 2006 compared with those of 1998.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 1.American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons, Bonow RO, Carabello BA, Kanu C, et al.: ACC/ AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society of Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006, 114:E84–E231. [Published erratum appears in Circulation 2007, 115:E409.]PubMedCrossRefGoogle Scholar
- 2.Bonow RO, Carabello B, de Leon AC, Jr, et al.: Guidelines for the management of patients with valvular heart disease: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Valvular Heart Disease). Circulation 1998, 98:1949–1984.PubMedGoogle Scholar
- 3.Wilson W, Taubert KA, Gewitz M, et al.: Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007, 116:1736–1754.PubMedCrossRefGoogle Scholar