Author + information
- Received November 18, 2018
- Revision received January 17, 2019
- Accepted January 21, 2019
- Published online April 1, 2019.
- Maninder Singh, MBBSa,b,∗ (, )@Maninde05501655@GuthrieClinic,
- Zachary A. Sporn, BSb,
- Hartzell V. Schaff, MDc and
- Patricia A. Pellikka, MDd@pattypellikka
- aDepartment of Cardiology, Guthrie Medical Group/Robert Packer Hospital, Sayre, Pennsylvania
- bGeisinger Commonwealth School of Medicine, Scranton, Pennsylvania
- cDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
- dDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
- ↵∗Address for correspondence:
Dr. Maninder Singh, Department of Cardiology, Guthrie Medical Group/Robert Packer Hospital, 1 Guthrie Square, Sayre, Pennsylvania 18840.
• Prosthetic heart valve replacement for native valve dysfunction is akin to trading one heart disease for another, warranting long-term follow-up and management.
• This review highlights the main areas of disagreement between 2 societal practice guidelines.
• The differences highlighted may help clinical decision-making with more cognizance of limitations of available evidence and catalyze future research.
Prosthetic heart valve interventions continue to evolve with new innovations in surgical and transcatheter technologies. We compared the recommendations from the 2017 American College of Cardiology/American Heart Association guidelines for management of patients with prosthetic heart valves with the 2017 European Society of Cardiology guidelines. The 2 documents differed regarding recommendations for follow-up imaging, the choice of biological versus mechanical prosthesis, bridging therapies, role of aspirin, use of fibrinolytic therapy for prosthetic valve thrombosis, and management of paravalvular regurgitation. This review highlights the differences between the 2 guidelines, summarizes new evidence, and offers recommendations for the management of patients with prosthetic heart valves in these areas of controversy.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received November 18, 2018.
- Revision received January 17, 2019.
- Accepted January 21, 2019.
- 2019 American College of Cardiology Foundation
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