According to an article published in Medscape, guidelines for the treatment of valvular heart disease have changed. The American College of Cardiology (ACC), along with the American Heart Association (AHA), have updated the management of patients with this condition, focusing specifically on less invasive treatments.
About Valvular Heart Disease
Valvular heart disease occurs when the any of the four valves in the heart fail to function correctly. In a normally functioning heart, the valves open and close to allow for proper blood flow. In a patient with this condition, the valves are unable to work correctly, leading to regurgitation and/or stenosis. The former occur when the valves do not shut all the way, letting the blood flow backwards. The latter is also known as the narrowing of a valve, and it forces the heart to pump harder to get the blood out of the narrowed opening.
If either of these problems are present, one may experience chest pain, fatigue, shortness of breath, dizziness, palpitations, abdominal pain, leg swelling, and high or low blood pressure. These symptoms can be the result of a number of causes, such as birth defects, syphilis, infections of the valves, coronary artery disease, heart attacks, aging that causes changes to the structure of the valves, and myxomatous degeneration. This condition can lead to heart failure, so it is important to seek treatment, which consists of medication, surgery, or a non-surgical procedure called balloon valvuloplasty.
Updates on Treatment
The new, updated guidelines replace older versions from 2014 and 2017. They have been published in two journals: Circulation and the Journal of the American College of Cardiology.
One of the major changes implemented by the two groups focuses on care for older individuals. They now suggest a transcatheter aortic valve implantation rather than surgical implantation, as it is less invasive, and its durability is better for the life expectancy of older patients. This means that patients will no longer have to spend an extended period of time in the hospital for a surgery. Instead, they could be out after only one night in the hospital.
A second recommendation that the new guidelines make is the transcatheter approach to repair or replace the mitral valve. This suggestion is aimed at individuals at a high or prohibitive risk of surgery. It’s a simpler, faster approach that leads to less time in the hospital and less time in recovery.
A tiered approach to the United States healthcare system is the next recommendation that the ACC and AHA make. They propose that affected individuals who require a complex treatment plan are taken care of at comprehensive, high-volume centers, whereas those who have simpler conditions receive their care at primary heart valve centers. This option allows for patients to receive the treatment that is best for them. In order for it to function fully, doctors would have to refer their patients to the correct center, the two organizations note.
Looking Forward
The new changes to these guidelines will lead to excellent outcomes for patients while still allowing full access to healthcare. They give medical professionals the tools they need to provide their patients with the best care.
