The American Heart Association requests that this document be cited as follows: Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A, Toly C. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;143:e72-e227. doi: 10.1161/CIR.0000000000000923 Key Words: AHA Scientific Statements anticoagulation therapy aortic regurgitation aortic stenosis bicuspid aortic valve cardiac surgery guidelines infective endocarditis mitral regurgitation mitral stenosis mitral transcatheter edge-to-edge repair prosthetic valve pulmonic regurgitation pulmonic stenosis transcatheter aortic valve replacement or implantation tricuspid regurgitation tricuspid stenosis valvular heart disease CLINICAL STATEMENTS AND GUIDELINES TABLE OF CONTENTS Top 10 Take-Home Messages . . . . . . . . . . . . . . . . . . . . . . . . e74 Preamble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e75 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e76 1.1. Methodology and Evidence Review . . . . . . . . . . . . e76 1.2. Organization of the Writing Committee . . . . . . . . e76 1.3. Document Review and Approval . . . . . . . . . . . . . . e76 1.4. Scope of the Guideline . . 