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Heart valve disease is a condition in which one or more of your heart valves don't work properly.

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Treatment of heart valve disease during pregnancy

Heart valve disease constitutes the majority of all causes of heart disease during pregnancy. Women with heart valve disease are vulnerable to deterioration with subsequent increased risk of maternal and fetal morbidity and mortality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Acute Heart Failure: Diagnosing and Managing Acute Heart Failure in Adults

The need for this guideline was identified as the NICE guidelines on chronic heart failure were being updated. We recognised at this time that there were important aspects of the diagnosis and management of acute heart failure that were not being addressed by the chronic heart failure guideline, which focussed on long term management rather than the immediate care of someone who is acutely unwell as a result of heart failure. The aim of this guideline is to provide guidance to the NHS on the diagnosis and management of acute heart failure.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: October 2014
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Effects of remote ischaemic preconditioning in patients undergoing coronary artery bypass graft surgery (with or without valve surgery)

We reviewed the evidence about the effect of remote ischaemic preconditioning (RIPC, the temporary blockage of arterial blood flow to one arm or one leg before surgery after induction of anaesthesia) in people undergoing coronary artery bypass graft surgery with or without additional valve surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Intraoperative echocardiography in valvular heart disease: an evidence-based appraisal

This review concluded that intraoperative transoesophageal echocardiography may offer considerable benefit in valvular repairs and mitral replacements; the value of IOTEE in isolated aortic valve replacement remained less clear. Limitations in both the review and its included studies mean that the results and conclusions should be treated with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Risk of valvular heart disease associated with the use of dopamine agonists in Parkinson's disease: a systematic review

This review assessed the frequency of cardiac valve regurgitation in patients with Parkinson's Disease treated with ergot-derived and non-ergot dopamine agonists, concluding that ergot-derived dopamine agonists (such as pergolide and cabergoline) increased their frequency. Given the variation across studies and shortcomings highlighted in the review process and reporting, the authors' conclusions should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Chronic Kidney Disease (Partial Update): Early Identification and Management of Chronic Kidney Disease in Adults in Primary and Secondary Care

The Renal National Service Framework (NSF), and the subsequent NICE Clinical Practice Guideline for early identification and management of adults with chronic kidney disease (CKD) in primary and secondary care (CG73), served to emphasise the change in focus in renal medicine from treatment of established kidney disease to earlier identification and prevention of kidney disease.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: July 2014
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Perceval S Sutureless Valve for Aortic Valve Replacement: A Review of the Clinical Effectiveness, Safety, and Cost-Effectiveness [Internet]

The Perceval S sutureless valve consists of a bioprosthetic valve mounted on a self-expanding nitinol stent. It received European regulatory approval in January 2013, and is currently undergoing US registration trials. In Canada it is available on a named-patient basis through the Health Canada special access program. This report reviews the evidence for the effectiveness, safety and cost effectiveness for the Perceval S sutureless valve for patients with aortic stenosis.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 29, 2015
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Identification and Management of Familial Hypercholesterolaemia (FH) [Internet]

While the NHS in England and Wales has made spectacular progress in improving the secondary prevention of cardiovascular disease, we now need to work harder to identify those who are at particularly high risk of myocardial infarction.

NICE Clinical Guidelines - National Collaborating Centre for Primary Care (UK).

Version: August 2008
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Clinical effectiveness and cost-effectiveness of second- and third-generation left ventricular assist devices as either bridge to transplant or alternative to transplant for adults eligible for heart transplantation: systematic review and cost-effectiveness model

This study found that while pulsatile ventricular assist devices used as bridge to heart transplant for advanced heart failure were clinically effective compared with medical management using inotropes, they failed to reach the standard level of cost-effectiveness set by the National Institute for Health and Care Excellence. It is clear that the technology is improving and currently in the base-case analysis over a lifetime horizon, cost-effectiveness approaches that for interventions adopted by the NHS as end of life treatments..

Health Technology Assessment - NIHR Journals Library.

Version: November 2013
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Meta-analysis of heart valve abnormalities in Parkinson's disease patients treated with dopamine agonists

This review concluded that valvular heart disease occurs at a similar frequency in Parkinson's disease patients who are treated with two dopamine agonists, and around 26% of these patients show signs of moderate valvular disease. Overall, the review process is likely to have been susceptible to various biases, and the conclusions do not necessarily follow from the presented results.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Home telemonitoring or structured telephone support programmes after recent discharge in patients with heart failure: systematic review and economic evaluation

Study found that, despite wide variation in usual care and remote monitoring strategies for patients who have been recently discharged (within 28 days) from acute care after a recent exacerbation of heart failure, cost-effectiveness analyses suggested that telemonitoring during office hours is an optimal strategy in most costing scenarios but that further research is needed.

Health Technology Assessment - NIHR Journals Library.

Version: August 2013
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Chronic Heart Failure: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care: Partial Update [Internet]

This guideline is a partial update of NICE Guideline No 5: Chronic Heart Failure - national clinical guideline for diagnosis and management in primary and secondary care (2003). The aim of the 2003 guideline was to offer best practice advice on the care of adult patients (aged 18 years or older) who have symptoms or a diagnosis of chronic heart failure. It defined the most effective combination of symptoms, signs and investigations required to establish a diagnosis of heart failure, and those which would influence therapy or provide important prognostic information. It also gave guidance on the treatment, monitoring and support of patients with heart failure.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: August 2010
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Implantable cardioverter defibrillators for the treatment of arrhythmias and cardiac resynchronisation therapy for the treatment of heart failure: systematic review and economic evaluation

Study found that implantable cardiac defibrillators reduced all-cause mortality in people at increased risk of sudden cardiac death as a result of previous ventricular arrhythmias or cardiac arrest, remote myocardial infarction or ischaemic/non-ischaemic heart failure and LVEF ≤ 35%. Cardiac resynchronisation therapy reduced all-cause mortality and improved other outcomes in people with heart failure as a result of left ventricular systolic dysfunction and cardiac dyssynchrony when compared with optimal pharmacological therapy. The devices were cost-effective at a willingness-to-pay threshold of £30,000 when compared with optimal pharmacological therapy.

Health Technology Assessment - NIHR Journals Library.

Version: August 2014
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Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

The study found that dual-chamber pacemakers appeared to be cost-effective compared with single-chamber pacemakers in patients with bradycardia due to sick sinus syndrome without atrioventricular block.

Health Technology Assessment - NIHR Journals Library.

Version: August 2015
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Oral anticoagulant therapy in patients with mechanical heart valve and intracranial haemorrhage: a systematic review

The optimal management of oral anticoagulant therapy after intracranial bleeding secondary to vitamin K antagonist use in patients with a mechanical heart valve was investigated. The authors concluded that restarting or stopping anticoagulant therapy for a few days appeared to be safe, but the quality of evidence was low. The review was generally well conducted and the authors' conclusions appear appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Impact of maze and concomitant mitral valve surgery on clinical outcomes

This review compared mitral valve surgery plus maze procedure versus surgery alone in patients with atrial fibrillation. The authors concluded that adding the maze procedure is associated with an improvement in conversion to sinus rhythm and a possible reduction in embolic events, but does not improve survival. Methodological and reporting limitations mean that the conclusions should be treated with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Cabergoline therapy and the risk of cardiac valve regurgitation in patients with hyperprolactinemia: a meta-analysis from clinical studies

The authors concluded that patients with hyperprolactinaemia who were treated with cabergoline were at increased risk of tricuspid valve regurgitation. The authors’ conclusions appeared to be supported by the limited evidence, but lack of reporting of review methods and study quality mean that their reliability is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Preservation of the mitral valve apparatus: evidence synthesis and critical reappraisal of surgical techniques

This review concluded that mitral valve replacement with preservation was superior to replacement without preservation for early postoperative low cardiac output that required inotropic support and for early or mid-term survival. Due to possible inappropriate pooling of studies and failure to consider study quality these conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

The role of valve surgery in infective endocarditis management: a systematic review of observational studies that included propensity score analysis

This review evaluated the role of valve surgery in infective endocarditis and found conflicting evidence for a reduction in all-cause mortality, which did not support the current American Heart Association guidelines. The review was generally well-conducted, but the reliability of the authors’ conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement

This review concluded that mitral valve repair was more beneficial than replacement surgery in patients with non-ischaemic mitral valve disease. There were no differences in total mortality between repair and replacement of the ischaemic mitral valve in the long term. In view of the methodological weaknesses of the review, the authors' conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

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