Arq. Bras. Cardiol. 2020; 115(4): 720-775
Update of the Brazilian Guidelines for Valvular Heart Disease – 2020
Flavio Tarasoutchi
, Marcelo Westerlund Montera, Auristela Isabel de Oliveira Ramos, Roney Orismar Sampaio
, Vitor Emer Egypto Rosa
, Tarso Augusto Duenhas Accorsi
, Antonio de Santis
, João Ricardo Cordeiro Fernandes, Lucas José Tachotti Pires, Guilherme S. Spina
, Marcelo Luiz Campos Vieira, Paulo de Lara Lavitola, Walkiria Samuel Ávila
, Milena Ribeiro Paixão, Tiago Bignoto
, Dorival Júlio Della Togna, Evandro Tinoco Mesquita
, William Antônio de Magalhães Esteves, Fernando Atik
, Alexandre Siciliano Colafranceschi
, Valdir Ambrósio Moises
, Alberto Takeshi Kiyose
, Pablo M. A. Pomerantzeff
, Pedro A. Lemos
, Fabio Sandoli de Brito Junior, Clara Weksler
, Carlos Manuel de Almeida Brandão, Robinson Poffo
, Ricardo Simões, Salvador Rassi
, Paulo Ernesto Leães, Ricardo Mourilhe-Rocha
, José Luiz Barros Pena, Fabio Biscegli Jatene
, Márcia de Melo Barbosa, Alexandre Abizaid
, Henrique Barbosa Ribeiro, Fernando Bacal
, Carlos Eduardo Rochitte
, José Honório de Almeida Palma da Fonseca, Samira Kaissar Nasr Ghorayeb
, Marcelo Antonio Cartaxo Queiroga Lopes
, Salvador Vicente Spina, Ricardo H. Pignatelli, José Francisco Kerr Saraiva
1. Introduction
There are currently a wide modalities of interventional strategies – both transcatheter and surgical – which can be indicated for patients with valvular heart diseases (VHD), with the objective of reducing the morbidity and mortality. The correct timing for indication and the type of interventional treatment are linked to the precise anatomical and functional diagnosis of the VHD, and comprehensive global evaluation of the patient. The 2020 Update of the Brazilian Guidelines for VHD, in addition to compiling scientific evidence and expert opinion, continues with the ideal of being useful in supporting decision making for patients with VHD, and has three unique characteristics, namely:
This 2020 edition considers the evaluation process for patients with non-severe VHD, and it emphasizes the need to weigh the possibility of transcatheter intervention in elderly patients, regardless of surgical risk, in addition patients with native or prosthetic valves with high surgical risk. Notwithstanding great advances and increased availability of imaging exams, these guidelines maintain the recommendation of detailed clinical evaluation, which continues to be indispensable to diagnosis, decisions making, and the doctor-patient relationship.
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