The focus of this guideline is the diagnosis and management of adult patients with valvular heart disease (VHD). A full revision of the original 1998 VHD guideline was made in 2006, and an update in 2008. Some recommendations from the earlier VHD guidelines have been updated as warranted by new evidence or a better understanding of earlier evidence; others that were inaccurate, irrelevant, or overlapping were deleted or modified.