What is new in ACC/AHA 2017 focused update of valvular heart disease guidelines

Rapid developments and new evidence in the field of medicine urge scientific communities to provide new guidelines. Valvular heart disease (VHD) can be considered as one of the most rapidly progressing fields of cardiology. Hence, ACC/AHA has very recently released a focused update only 3 years after the latest 2014 guidelines on VHD (1). The key changes that reflect the new advances in this update can be summarized as follows: 1- Infective endocarditis: Although limited prophylaxis is still underscored in the focused update, all implanted prosthetic materials used in transcatheter or surgical procedures for VHD are now considered to be a reasonable indication for antibiotic prophylaxis. In patients with infective endocarditis and an indication for surgery, a delay in the procedure is deemed unnecessary unless a hemorrhagic or major embolic stroke is present. Otherwise, delaying surgery for 4 weeks may be reasonable based on nonrandomized data.