Shared decision-making between the patient and heart team is based on lifetime risks and benefits of mechanical vs. bioprosthesis and transcatheter vs. surgical intervention.
Surgical risk stratification is no longer a factor for therapy selection.
Patients with severe VHD should be evaluated by a multidisciplinary heart valve team when intervention is considered.ACC/AHA 2020 Guidelines
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Otto CM, Nishimura RA, Bonow RO. et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online December 17. 2020.