Indications for transcatheter aortic valve implan- tation are expanding as a result of multiple randomized trials of transcatheter aortic valve implantation versus surgical aortic valve replace- ment. The choice of type of intervention for a patient with severe aortic stenosis should be a shared decision-making process that considers the lifetime risks and benefits associated with type of valve (mechanical versus bioprosthetic) and type of approach (transcatheter versus surgical). 7. Indications for intervention for valvular regurgi- tation are relief of symptoms and prevention of the irreversible long-term consequences of left ventricular volume overload. Thresholds for inter- vention now are lower than they were previously because of more durable treatment options and lower procedural risks. 8. A mitral transcatheter edge-to-edge repair is of benefit to patients with severely symptomatic primary mitral regurgitation who are at high or prohibitive risk for surgery, as well as to a select subset of patients with secondary mitral regurgi- tation who remain severely symptomatic despite guideline-directed management and therapy for heart failure. 9. Patients presenting with severe symptomatic iso- lated tricuspid regurgitation, commonly associ- ated with device leads and atrial fibrillation, may benefit from surgical intervention to reduce symp- toms and recurrent hospitalizations if done before CLINICAL STATEMENTS AND GUIDELINES the onset of severe right ventricular dysfunction or end-organ damage to the liver and kidney. 10. Bioprosthetic valve dysfunction may occur because of either degeneration of the valve leaflets or valve thrombosis. Catheter-based treatment for prosthetic valve dysfunction is reasonable in selected patients for bioprosthetic leaflet degeneration or paravalvular leak in the absence of active infection. PREAMBLE Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated sci- entific evidence into clinical practice guidelines with recom- mendations to improve cardiovascular health. 