2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease
The 2020 ACC/AHA valve guideline builds its aortic-stenosis pathway on age rather than on surgical risk score: surgical replacement is preferred below 65 years, transcatheter replacement above 80, and between 65 and 80 the choice is shared with the patient. That is a markedly more conservative age line than the ESC/EACTS 2025 guideline, which makes TAVI a reasonable option from 70 years and reframes the whole decision as lifetime management. In mitral regurgitation the guideline separates primary (degenerative) from secondary disease and confines transcatheter edge-to-edge repair to the COAPT phenotype. Trials that appeared after 2020 — the early-intervention and low-risk-TAVI studies now driving the European position — are listed separately below.
This guideline cites 8 of the 199 landmark trials in our Cardiology register.
Aortic stenosis — TAVI vs. SAVR4
- 2019PARTNER 3Cardiology · Structural · TAVRTranscatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients
- 2019Evolut Low RiskCardiology · Structural · TAVRTranscatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients
- 2016PARTNER 2ACardiology · Structural · TAVRPlacement of Aortic Transcatheter Valves 2, Cohort A
- 2010PARTNER 1BCardiology · Structural · TAVRPlacement of Aortic Transcatheter Valves — cohort B (inoperable)
Mitral regurgitation — transcatheter repair3
- 2018COAPTCardiology · Structural · MitralCardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
- 2018MITRA-FRCardiology · Structural · MitralPercutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
- 2011EVEREST IICardiology · Structural · MitraClipEndovascular Valve Edge-to-Edge Repair Study II
Prosthetic valves — anticoagulation1
- 2013RE-ALIGNCardiology · Structural · AnticoagulationDabigatran versus Warfarin in Patients with Mechanical Heart Valves
Published since the guideline5
- 2025EARLY TAVRCardiology · Structural · TAVRTranscatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis
- 2024NOTION-2Cardiology · Structural · TAVRNordic Aortic Valve Intervention 2
- 2023TRILUMINATECardiology · Structural · TricuspidTranscatheter Repair for Patients with Tricuspid Regurgitation
- 2022AVATARCardiology · Structural · early AVRAortic Valve replAcemenT versus conservative treatment in Asymptomatic seveRe aortic stenosis
- 2022PROTECTED TAVRCardiology · Structural · cerebral embolic protectionStroke PROTECTion With SEntinel During Transcatheter Aortic Valve Replacement