Nouvelles recommandations de l`ESC sur la gestion des

Traduction+des+recommandations+ESC+sur+la+gestion+des+pathologies+valvulaires+cardiaques+(version+
2012)+pour+le+site+de+la+cardiologie=francophone+par+le+Dr+François+Boustani+
+
+
1+
!
"#!$#%$#!&'()*+*,#!-!./*&#0*,#1!(,!$2#!34,4+#3#,$!(5!6406/04)!2#4)$!&*1#41#!76#)1*(,!89:8;!
</)(=#4,!>#4)$!?(/),40!789:8;!@@A!8BC:D8BEF!
!
G,$)(&/H$*(,!=4)!I)4,J(*1!K(/1$4,*!-!0#1!)#H(334,&4$*(,1!&#!0'<LM!1/)!04!=4$2(0(+*#!6406/04*)#!
1(,$! $)N1! 4$$#,&/#1! &'4/$4,$! O/'#00#1! 1(,$! &*)*+P#1! =4)! Q0#H! R424,*4,! #$! 1*+,P#1! =4)! K#),4)&!
G/,+S!"4!,(/6#4/$P!H#$$#!4,,P#!)P1*&#!&4,1!0#!54*$!O/#!0'<LM!1'#1$!411(H*P#!T!0'<QMUL!7</)(=#4,!
Q11(H*4$*(,! 5()! M4)&*(VU2()4H*H! L/)+#)W;! =(/)! P04X()#)! &#1! ! )#H(334,&4$*(,1! H(33/,#1! 1/)!
0#1!6406#1!1(/1!04!=)P1*&#,H#!&'Q0#H!R424,*4,!=(/)!0'<LM!#$!&'Y$$46*(!Q05*#)*!=(/)!0'<QMULS!
Z#/%!=(*,$1!*3=()$4,$1!&4,1!H#1!)#H(334,&4$*(,1!-!!
•"#1! 4/$#/)1! ,(/1! *,6*$#,$! T! =)(HP&#)! =(/)! H24O/#! =4$*#,$! T! /,! #%#)H*H#! &#! H(2P)#,H#!
#,$)#!0#1!&(,,P#1!&#!0'*,$#))(+4$(*)#A!&#!0'#%43#,!H0*,*O/#!#$!&#1!#%43#,1!H(3=0P3#,V
$4*)#1!#,!(=P)4,$!1#0(,!/,!1H2P34!#,!1#=$!P$4=#1!O/*!#1$!&P$4*00P!&4,1!0#!$4X0#4/!@S!
•M#1!)#H(334,&4$*(,1!*,$)(&/*1#,$!0#!H(,H#=$!&'/,![!>#4)$!U#43!\!H'#1$VTV&*)#!&'/,#!H(0V
04X()4$*(,!4/!1#*,!&'/,#!3]3#!PO/*=#!54*$#!&#!H4)&*(0(+/#1A!H2*)/)+*#,1!H4)&*4O/#1A!1=PV
H*40*1$#1! &#! 0'*34+#)*#! H4)&*4O/#!7/0$)41(,A! G^_! #$! 1H4,,#);A! 4,#1$2P1*1$#1! #$! +P)*4$)#1!
&4,1!0#!H41!&#1!=#)1(,,#1!`+P#1!O/*!1(,$!0#1!=0/1!H(,H#),P#1!=4)!0#!UQRGS!M#$$#!&*1H/1V
1*(,!3P&*H(VH2*)/)+*H40#!1/==(1#!04!=)P1#,H#!&'/,!1#)6*H#!&#!H2*)/)+*#!H4)&*4O/#!1/)!0#!
1*$#A!H(,&*$*(,!(X0*+4$(*)#!T!04!640*&4$*(,!&#!H#!&#),*#)!=(/)!0#!UQRGS!
!
"#1!,(/6#4/$P1!&#1!)#H(334,&4$*(,1!89:8!&4,1!0'*,1/55*14,H#!3*$)40#!-!&'4X()&!/,!H24,+#3#,$!
1P34,$*O/#A! 0'G_! ()+4,*O/#! =#)&! 1(,! ,(3! =(/)! &#6#,*)! 0'G_! =)*3*$*6#! =4)! (==(1*$*(,! T! 0'G_!
1#H(,&4*)#! JVTV&! 5(,H$*(,,#00#!(/! *1H2P3*O/#S! a(/)! 0#! )#1$#A! =#/! &#! H24,+#3#,$1! =4)! )4==()$!
4/%! )#H(334,&4$*(,1! &#! 0'<LM! 899bA! 14/5! =(/)! 0#! =4$*#,$! 41W3=$(34$*O/#! 4W4,$! /,! &*43N$)#!
$P0P1W1$(0*O/#!&/! R.! cB9! 33! O/*! &#6*#,$A! &4,1! 0#1! ,(/6#00#1! )#H(334,&4$*(,1A! P0*+*X0#! T! 04!
H2*)/)+*#A! $(/$#5(*1! T! &#/%! H(,&*$*(,1! -! O/'*0! W! 4*$! /,#! 5()$#! =)(X4X*0*$P! &#! =041$*#! #$! /,! )*1O/#!
(=P)4$(*)#!54*X0#S!M#$$#!)#H(334,&4$*(,!7H0411#!GG4;!4!P$P!P$4X0*#!#,!1#!5(,&4,$!1/)!0#1!)P1/0$4$1!
&/!)#+*1$)#!_GZQ!=/X0*P!#,!899E!=4)!M2)*1$(=2#!U)*X(/*00(WS!
_(*,1! *3=()$4,$#A! 1#/0#3#,$! #,! H0411#! GGXA! #1$! 0'*,&*H4$*(,! (=P)4$(*)#! #,! H41! &'/,#! >UQa! T!
0'#55()$! c! F9! 332+! 1/)6#,4,$! 0()1! &'/,#! PH2(+)4=2*#! &'#55()$! #,! 1#! X414,$! 1/)! 0#1! $)464/%! &#!
a4$)*d*(!"4,H#00($$*!7"*N+#;!(/!/,!6(0/3#!&#!0'()#*00#$$#!+4/H2#!cF9!30e38!O/*!#1$!4/11*!#,!H0411#!
GGXS!
!<,!H#!O/*!H(,H#),#!0'*,1/55*14,H#!3*$)40#!*1H2P3*O/#!&#/%!=#$*$#1!,(/6#4/$P1!-!
:S "#! _*$)4! H0*=! O/*! =#/$! ]$)#! #,6*14+P! 7H0411#! GGXA! M;! H2#d! 0#1! =4$*#,$1! 1W3=$(34$*O/#1!
4W4,$!/,#!G_!1P6N)#!,(,!(=P)4X0#!(/!T!)*1O/#!H2*)/)+*H40#!$)N1!P0#6P!#$!/,#!#1=P)4,H#!&#!
6*#!c:!4,!7P$/&#!<R<^<LU;S!
8S "'PH2(! &'#55()$! O/*! H(,5()$#! 0'*,&*H4$*(,! (=P)4$(*)#! H2#d! 0#1! =4$*#,$1! =()$#/)1! &'/,#! G_!
3(&P)P#! #$! O/*! &(*6#,$! 1/X*)! /,#! H2*)/)+*#! &#! =(,$4+#! 4()$(VH()(,4*)#! #,! H41!
&'4==4)*$*(,!&'/,#!&W1=,P#!T!0'#55()$!#,! )4==()$!46#H!/,#! 34f()4$*(,!&#!04!5/*$#!#$!/,#!
P0P64$*(,!&#1!=)#11*(,1!=/03(,4*)#1S!!

Traduction+des+recommandations+ESC+sur+la+gestion+des+pathologies+valvulaires+cardiaques+(version+
2012)+pour+le+site+de+la+cardiologie=francophone+par+le+Dr+François+Boustani+
+
+
2+
"#1!,(/6#4/$P1!&#1!)#H(334,&4$*(,1!89:8!&4,1! 0'*,1/55*14,H#!4()$*O/#V&*04$4$*(,!&#!04! )4H*,#!
4()$*O/#!1(,$!-!
Z4,1!04!3404&*#!&#!_4)54,!-!0#!1#/*0!T!=4)$*)!&/O/#0!/,#!H2*)/)+*#!#1$!*,&*O/P#!4!P$P!P0#6P!&#!BC!
33!&4,1!0#1!)#H(334,&4$*(,1!<LM!899b!T!C9!33!&4,1!0#1!,(/6#00#1!)#H(334,&4$*(,1!#,!1#!
X414,$!1/)!/,#!P$/&#!(X1#)64$*(,,#00#!&/!a)!?(,&#4/!7>g=*$40!K*H24$;!H(3=()$4,$!b99!=4$*#,$1!
46#H! /,! 1/*6*! 3(W#,! &#! F! 4,1S! U(/$#5(*1! 0#! 1#/*0! &#! BC! 33! )#1$#! 640*&#A! 46#H! /,#!
)#H(334,&4$*(,! &#! H0411#! GG4A! #,! H41! &#! =)P1#,H#! &#! 54H$#/)1! &#! )*1O/#! &#! &*11#H$*(,!-!
=)(+)#11*(,!&/!&*43N$)#!4()$*O/#!c!8!33!=4)!4,A!/,!4,$PHP&#,$!543*0*40!&#!&*11#H$*(,A!/,!&P1*)!
&#!+)(11#11#!(/!/,#!*,1/55*14,H#!4()$*O/#!(/!3*$)40#!*3=()$4,$#S!^#1$#!0#!H41!=4)$*H/0*#)!&'/,#!
*,&*H4$*(,!H2*)/)+*H40#!=(/)!04!6406#!4()$*O/#A!&4,1!H#!H41!/,!+#1$#!411(H*P!1/)!0'4()$#!=#/$!]$)#!
H(,1*&P)P!=(/)!/,!&*43N$)#!=0/1!X41!O/#!0#1!C9!33!(55*H*#01S!
Z4,1!04!X*H/1=*&*#!-!0#!1#/*0!T!=4)$*)!&/O/#0!/,#!H2*)/)+*#!#1$!*,&*O/P#!4!P$P!P0#6P!&#!C9!33!&4,1!
0#1! )#H(334,&4$*(,1! <LM! 899b! T! CC! 33! &4,1! 0#1! ,(/6#00#1! )#H(334,&4$*(,1! #$! H#H*! #,! 1#!
X414,$!1/)!&#/%!P$/&#1!4==4)/#1!$(/$#1!&#/%!#,!899hS!U(/$#5(*1!0#!1#/*0!&#!C9!33!)#1$#!640*&#A!
46#H!/,#!)#H(334,&4$*(,!&#!H0411#!GG4A!#,!H41!&#!=)P1#,H#!&#!54H$#/)1!&#!)*1O/#!&#!&*11#H$*(,!-!
/,! 4,$PHP&#,$! 543*0*40! &#! &*11#H$*(,A! /,! &P1*)! &#! +)(11#11#A! /,#! H(4)H$4$*(,A! /,#! >UQ! (/! /,#!
=)(+)#11*(,!&/!&*43N$)#!4()$*O/#!c!8!33!=4)!4,S!Q!,($#)!O/#!=(/)!04!X*H/1=*&*#!H(33#!=(/)!0#!
_4)54,A! 0'P6(0/$*6*$P! 1#)4! f/+P#! #,! 1'#,$(/)4,$! &'/,! H#)$4*,! ,(3X)#!&#! =)PH4/$*(,1! 73#1/)#1!
)P=P$P#1!#,! /$*0*14,$! 04! 3]3#!$#H2,*O/#!#$!#,!#55#H$/4,$! 04! 3#1/)#!4/!3]3#!,*6#4/!&#!0i4()$#!
46#H!H(,5*)34$*(,!=4)!/,#!4/$)#!$#H2,*O/#!&'*34+#)*#;S!
a(/)!0#1!4/$)#1!H41!0#!&*43N$)#!1#/*0!T!=4)$*)!&/O/#0A!*0!54/$!#,6*14+#)!/,#!H2*)/)+*#!=)P6#,$*6#!
)#1$#!T!CC!33S!!!!!!!!!!!!!!!!!
"#1!,(/6#4/$P1!&#1!)#H(334,&4$*(,1!89:8!=(/)!0#!^QM!-!
j(/6#4/$P!=(/)!0'P640/4$*(,!&/!^QM!-!!
•"4! 1/)54H#! 4()$*O/#!-! =41! &#! H24,+#3#,$! =(/)! 04! 1/)54H#A!k! T! :H38A! #00#! &P5*,*$! 0#! ^QM!
1#))PA!,P4,3(*,1! 04! ,(/6#4/$P! #1$! &'4&3#$$)#! O/'/,#! 1/)54H#! T! 9SE! H38! =#/$! ]$)#!
H(3=4$*X0#! 46#H! /,! ^QM! 3(&P)P! H2#d! 0#1! =4$*#,$1! &#! =#$*$#! $4*00#! &'(l! 04! ,PH#11*$P!
&'*,&#%#)!04!1/)54H#!=4)!)4==()$!T!04!1/)54H#!H()=()#00#!#$!0#!^QM!1#)4!H(,1*&P)P!H(33#!
1#))P! 1*! 04! 1/)54H#! *,&#%P#! #1$! k9SFH38e38! &#! 1/)54H#! H()=()#00#S! <,! )#64,H2#A! H#$$#!
*,&#%4$*(,!#1$!5()$#3#,$!&PH(,1#*00P#!H2#d!0#1!=4$*#,$1!(XN1#1!H4)!#00#!34f()#!04!1P6P)*$P!
&/!^QMS!!!
•"#! +)4&*#,$! 3(W#,!-! 4! P$P! X4*11P! &#! C9! T! B9! 332+! #,! H(,5()3*$P! 46#H! 0#1!
)#H(334,&4$*(,1!,()&V43P)*H4*,#1S!!!
•"'*,&#%! &#! =#)3P4X*0*$P!-! O/*!,#! 5*+/)4*$! =41! &4,1! 0#1! )#H(334,&4$*(,1! 899bA! 54*$! 1(,!
#,$)P#!-!*,5P)*#/)!T!8CmA!*0!#1$!H(,1*&P)P!H(33#!/,!H)*$N)#!&#!1P6P)*$PS!!
j(/6#4/$P1!=(/)!0#1!*,&*H4$*(,1!-!
•a4$*#,$1!41W3=$(34$*O/#1!-!0#1!)#H(334,&4$*(,1!43P)*H4*,#1!QMMeQ>Q!H0411#,$!0#!^QM!
$)N1! 1#))P! 7R34%! c! T! C! 3e;! #,! H0411#! GGXA! 40()1! O/'*0! ,#! 5*+/)4*$! =41! &4,1! 0#1!
)#H(334,&4$*(,1!#/)(=P#,,#1!899bS!M#$$#!,(/6#00#!6#)1*(,!<LM!89:8!#,!$*#,$!H(3=$#!
#$!)#$*#,$!/,#!R34%c!CSC!3e1#H!H(33#!*,&*H4$*(,!(=P)4$(*)#!#,!H0411#!GG4S!

Traduction+des+recommandations+ESC+sur+la+gestion+des+pathologies+valvulaires+cardiaques+(version+
2012)+pour+le+site+de+la+cardiologie=francophone+par+le+Dr+François+Boustani+
+
+
3+
Q0()1! O/#! 0'P0P64$*(,! &/! +)4&*#,$! 3(W#,! c89! 332+! T! 0'PH2(! &'#55()$! (/! 0#1! $4/%! &#!
KjaejUV=)(! Kja! P0#6P1! H(,5*)3P1! T! =0/1*#/)1! &(14+#1! 1/HH#11*51! ,#! 1(,$! O/'#,! H0411#!
GGXS!
"4! 1$P,(1#! 4()$*O/#! 1#))P#! 41W3=$(34$*O/#!46#H! &#1! $)(/X0#1! &#! )W$23#! 6#,$)*H/04*)#!
H(3=0#%#1! T! 0'#55()$A!*,&*H4$*(,! (=P)4$(*)#! #,! H0411#!GGX! &4,1! 0#1! )#H(334,&4$*(,1! <LM!
899bA!,'#1$!=0/1!T!0'()&)#!&/!f(/)!&4,1!H#$$#!6#)1*(,!89:8S!!!!!!
•a4$*#,$1!1W3=$(34$*O/#1!-!H#1!)#H(334,&4$*(,1!H(,5*)3#,$!0#!UQRG!H(33#!/,!=)#3*#)!
H2(*%A! #,! H0411#! GA! &4,1! 0#! ^QM! 1#))P! 1W3=$(34$*O/#! #,! H41! &#!H(,$)#V*,&*H4$*(,!
H2*)/)+*H40#!H(,5*)3P!=4)!0#![!>#4)$!U#43!\!#$!T!H(,&*$*(,!O/#!0'#1=P)4,H#!&#!6*#!1(*$!c:!
4,S! <,! )#64,H2#A! &4,1! 0#! 24/$! )*1O/#! (=P)4$(*)#! 0#1! &#/%! (=$*(,1! H2*)/)+*#! (/! UQRG!
)#1$#,$!=(11*X0#!#$!0#!H2(*%!)#6*#,$!4/![!>#4)$!U#43!\S!"#1!H(,$)#V*,&*H4$*(,1!&/!UQRG!(,$!
P$P!$(/$#1!P,/3P)P#1!7$4X0#4/!:9;S!!!
Z4,1!0#!^QM!1#))P![!=4)4&(%40!\! T! I<R.! =)P1#)6P#!c!C9mA!X41!&PX*$!#$!+)4&*#,$!3(W#,!
X41! k! T! B9! 332+A! 04! H2*)/)+*#! =#/$! ]$)#! #,6*14+P#! /,*O/#3#,$! H2#d! 0#! =4$*#,$!
1W3=$(34$*O/#!#$!T!H(,&*$*(,!O/'*0!W!4*$!/,!54*1H#4/!&'4)+/3#,$1!H(,H()&4,$1!#,!546#/)!
&#! 04! 1P6P)*$P!7H40H*5*H4$*(,! 6406/04*)#! *3=()$4,$#A!40$P)4$*(,! &#! 04! 5(,H$*(,!
0(,+*$/&*,40#;S!"'P640/4$*(,!&#1!H40H*5*H4$*(,1!=#/$!1#!54*)#!+)`H#!4/!1H4,,#)!#,!H40H/04,$!
0#! 1H()#! H40H*O/#!&'Q+4$1$(,!1#0(,! &#1! 3(&40*$P1! =)PH*1P#1! =4)!Z46*&! _#11*n4! o#*$(/,S!
Z4,1!1(,! $)464*0A! /,!1H()#! &#! :FC9!71H4,,#)!3/0$*X4)#$$#1;!=#)3#$$4*$!&#! =)P&*)#!46#H!
/,#!X(,,#! 1#,1*X*0*$P!#$! /,#!X(,,#! 1=PH*5*H*$P!/,#! 1$P,(1#!4()$*O/#!1#))P#S! p,! 1H()#! k!
C99!=#)3#$$4*$!&'#%H0/)#!/,#!1$P,(1#!1#))P#!7640#/)!=)P&*H$*6#!,P+4$*6#!&#!:99!m;!40()1!
O/'/,!1H()#!c!8q999!P$4*$!$)N1!#,!546#/)!&'/,#!1$P,(1#!1#))P#S!!
"#1!,(/6#4/$P1!&#1!)#H(334,&4$*(,1!89:8!&4,1!0#!)P$)PH*11#3#,$!3*$)40!-!=41!&#!3(&*5*H4$*(,!
=4)!)4==()$!T!H#00#1!&#!899bS!!
"#1!,(/6#4/$P1!&#1!)#H(334,&4$*(,1!89:8!=(/)!0#1!=)($2N1#1!-!
•M2(*%!&#!04!=)($2N1#!-!0'`+#!4!P$P!4X4*11P!&#!C!4,1!=4)!)4==()$!4/%!)#H(334,&4$*(,1!<LM!
899bA!#,!546#/)!&#!04!X*(=)($2N1#S!"4!=)($2N1#!3PH4,*O/#! &(*$! ]$)#! H(,1*&P)P#!H2#d!0#!
=4$*#,$!&#!3(*,1!&#!F9!4,1!#,!=(1*$*(,!4()$*O/#!#$!&#!3(*,1! &#!FC!4,1!#,!=(1*$*(,!3*V
$)40#S!a(/)!0#1!=4$*#,$1!`+P1!&#!F9VFC!4,1!O/*!&#6)4*#,$!)#H#6(*)!/,#!=)($2N1#!4()$*O/#A!
#$!0#1!=4$*#,$1!#,$)#!FCVb9!4,1!&4,1!0#!H41!&'/,#!=)($2N1#!3*$)40#A!0#1!&#/%!(=$*(,1!1(,$!
=(11*X0#1!#$!0#!H2(*%!,PH#11*$#!/,#!4,40W1#!4$$#,$*6#!&'4/$)#1!54H$#/)1!O/#!0i`+#S!
•U)4*$#3#,$!4,$*H(4+/04,$!-!#,!H41!&'/,#!=041$*#!3*$)40#!(/!&'/,#!X*(=)($2N1#!3*$)40#A!0#!
$)4*$#3#,$! 4,$*H(4+/04,$! #1$! *,&*O/P! 4/! H(/)1! &#1!$)(*1! =)#3*#)1! 3(*1! O/*! 1/*6#,$!
0'*,$#)6#,$*(,S! a(/)! 04! X*(=)($2N1#! 4()$*O/#A! 0'41=*)*,#! 1#/0#! #1$! *,&*O/P#! 4/! H(/)1! &#1!
$)(*1!=)#3*#)1!3(*1!O/*!1/*6#,$!0'*,$#)6#,$*(,S!!

Traduction+des+recommandations+ESC+sur+la+gestion+des+pathologies+valvulaires+cardiaques+(version+
2012)+pour+le+site+de+la+cardiologie=francophone+par+le+Dr+François+Boustani+
+
+
4+
<,!H(,H0/1*(,!-!0#1!,(/6#00#1!)#H(334,&4$*(,1!<LM!89:8!1(,$!/,#!X#00#!1W,$2N1#!&#1!464,HP#1!
&4,1! 0#! &(34*,#! &#1! 6406(=4$2*#1! H4)&*4O/#1! 1/)6#,/#1! 4/! H(/)1! &#1! H*,O! &#),*N)#1! 4,,P#1A!
,($433#,$!#,! H#! O/*! H(,H#),#! 0#! UQRG! O/*! 1'#1$! *3=(1P! 1/)! 0#! =04,! $2P)4=#/$*O/#S! _4*1! H#$$#!
#,$)P#!5)4H4114,$#!&#! 04! H4)&*(0(+*#!*,$#)6#,$*(,,#00#!&4,1! 0#! H243=! &#! 04!H2*)/)+*#!H4)&*4O/#!
,PH#11*$#!&']$)#!4HH(3=4+,P#!#$!#,H4&)P#S!M'#1$!=(/)O/(*A!H#1!)#H(334,&4$*(,1!*,1*1$#,$!1/)!04!
,PH#11*$P!&'/,#!&PH*1*(,!H(00P+*40#!4/!1#*,!&/![!>#4)$!U#43!\!46#H!04!=)P1#,H#!*3=P)4$*6#!&'/,!
1#)6*H#!&#!H2*)/)+*#!H4)&*4O/#!1/)!0#!1*$#S!!
"4! 1#/0#! $#H2,*O/#! O/*! 4! P$P! (HH/0$P#! &4,1! H#1! )#H(334,&4$*(,1! #1$! 0#! L$)4*,! 7*34+#)*#! &#!
&P5()34$*(,;!=4)!L=#Hn0#!U)4&*,+!=)(X4X0#3#,$!#,!)4*1(,!&/!=#/!&'P$/&#1!1/)!0#!1/f#$!#$!1/)$(/$!
&#! 0'4X1#,H#! &'/,*5()3*$P! &#1! 1#/*01! #,$)#! 0#1! &*55P)#,$1! 54X)*H4,$1! &'4==4)#*0! &'PH2(S! <00#! 4! #/!
&)(*$! T! /,#! H*$4$*(,! &4,1! 0'G_! #,! 1#! X414,$! 1/)! /,! $)464*0! &#! "4,H#00($$*! &#! 899hS! M#! O/*! 4! P$P!
H(,5*)3P!)PH#33#,$!=4)!/,#!4/$)#!P$/&#!=/X0*P#!#,!89:8!(l!/,!1$)4*,!+0(X40!0(,+*$/&*,40!."L!
r:hm!4!=#)3*1!&#!=)P6(*)!46#H!/,#!X(,,#!1=PH*5*H*$P!#$!/,#!X(,,#!1#,1*X*0*$P!04!&W15(,H$*(,!R.!
=(1$!(=P)4$(*)#!H2#d!&#1!=4$*#,$1!4W4,$!/,#!G_!#$!/,#!I<R.!=)P!(=P)4$(*)#!=)P1#)6P#!7?Q3!L(H!
<H2(H4)&*(+)S!89:8!f/0!s! 8C! 7b;!-! bFFVb8;S! "#1! ,(/6#00#1! )#H(334,&4$*(,1! ,'(,$! =41! )#$#,/! &#!
=04H#! 4/! L=#Hn0#! U)4&*,+! &4,1! 0#! ^QM! 340+)P! 0#1! 2W=($2N1#1! 1/)! /,#! 4$$#*,$#! &#! 04! 5(,H$*(,!
0(,+*$/&*,40#!&/#!T!/,#!5*X)(1#!&#1!1#+3#,$1!X414/%!&4,1!0#!^QM!T!54*X0#!&PX*$A!54*X0#!+)4&*#,$!#$!
I<R.!=)P1#)6P#S!Q!,($#)!O/'/,#!P$/&#!=/X0*P#!#,!89:8!4*$!3(,$)P!O/'/,!."L!r:Cm!#1$!411(H*P!T!
/,!34/64*1!=)(,(1$*H!&4,1!0#!^QM!41W3=$(34$*O/#A!*,&P=#,&433#,$!&#!04!6P0(H*$PA!&/!+)4&*#,$!
3(W#,!(/!&#!04!1/)54H#!7t#4),#W0!#$!40S!</)!>#4)$!?!H4)&*(641H!*34+*,+!89:8!s!C!-8bV@b;!$(/$#5(*1!
H#1!&(,,P#1!,#!1(,$!=41!1/55*14,$#1!=(/)!3(&*5*#)!,(1!=)4$*O/#1S!
!
M0411#1!&#!
)#H(334,&4$*(,!
ZP5*,*$*(,!
L/++#1$*(,!!&#!$#)3#1!
T!/$*0*1#)!
M0411#!G!
a)#/6#!#$e(/!4HH()&!+P,P)40!1/)!0#!54*$!O/'/,!
$)4*$#3#,$!(/!/,#!=)(HP&/)#!1(,$!XP,P5*O/#1A!
/$*0#1A!#55*H4H#1S!
<1$!)#H(334,&P7#;e!
#1$!*,&*O/P7#;!
M0411#!GG!
a)#/6#!&'/,!H(,50*$!#$e(/!/,#!&*6#)+#,H#!
&'(=*,*(,1!1/)!0'/$*0*$Pe#55*H4H*$P!&/!
$)4*$#3#,$!(/!&#!04!=)(HP&/)#!#,!O/#1$*(,S!
!
M0411#!GG4!
"#!=(*&1!&#!04!=)#/6#e(=*,*(,!#1$!#,!546#/)!
&#!0'/$*0*$Pe#55*H4H*$PS!
Z#6)4*$!]$)#!
H(,1*&P)P7#;S!
M0411#!GGX!
"'/$*0*$Pe#55*H4H*$P!#1$!3(*,1!X*#,!P$4X0*#!=4)!
04!=)#/6#e(=*,*(,S!
a#/$!]$)#!
H(,1*&P)P7#;S!
M0411#!GGG!
a)#/6#!(/!4HH()&!+P,P)40!1/)!0#!54*$!O/#!0#!
$)4*$#3#,$!(/!04!=)(HP&/)#!#,!O/#1$*(,!,'#1$!
=41!/$*0#e#55*H4H#A!#$!=#/$!]$)#!,/*1*X0#!&4,1!
H#)$4*,1!H41S!
j'#1$!=41!
)#H(334,&P7#;S!
!
j*6#4/%!&#!=)#/6#!
j*6#4/!&#!=)#/6#!
Q!
Z(,,P#1!*11/#1!&#!=0/1*#/)1!#114*1!H0*,*O/#1!)4,&(3*1P1!
(/!&#!3P$4V4,40W1#1S!
j*6#4/!&#!=)#/6#!
K!
Z(,,P#1!*11/#1!&'/,#!1#/0#!P$/&#!H0*,*O/#!)4,&(3*1P#!
(/!&#!+)4,&#1!P$/&#1!,(,!)4,&(3*1P#1S!
j*6#4/!&#!=)#/6#!
M!
M(,1#,1/1!&#!0'(=*,*(,!&#1!#%=#)$1!#$e(/!=#$*$#1!P$/&#1A!P$/&#1!
)P$)(1=#H$*6#1A!)#+*1$)#1S!

Traduction+des+recommandations+ESC+sur+la+gestion+des+pathologies+valvulaires+cardiaques+(version+
2012)+pour+le+site+de+la+cardiologie=francophone+par+le+Dr+François+Boustani+
+
+
5+
!
!
!
!
!
U4X0#4/!@!-!!
u/#1$*(,1!#11#,$*#00#1!T!1#!=(1#)!&4,1!0'P640/4$*(,!&'/,!=4$*#,$!464,$!/,#!H2*)/)+*#!6406/04*)#!
:S "4!6406/0(=4$2*#!#1$V#00#!1P6N)#!v!
8S "#!=4$*#,$!#1$V*0!1W3=$(34$*O/#!v!
@S "#1!1W3=$g3#1!1(,$V*01!#,!0*#,!46#H!04!6406/0(=4$2*#!v!
BS u/#00#!#1$!0'#1=P)4,H#!&#!6*#!&/!=4$*#,$!#$!14!O/40*$P!&#!6*#!v!
CS "#1!XP,P5*H#1!4$$#,&/1!&#!0'*,$#)6#,$*(,!&P=411#,$V*01!0#1!)*1O/#1!#,H(/)/1!v!
FS u/#0!#1$!0#!1(/24*$!&/!=4$*#,$!v!
bS "#1!)#11(/)H#1!0(H40#1!1(,$V#00#1!(=$*340#1!=(/)!0'*,$#)6#,$*(,!=)P6/#!v!
!
U4X0#4/!B!-!!
M)*$N)#1!PH2(+)4=2*O/#1!=(/)!&P5*,*)!04!1P6P)*$P!&#1!1$P,(1#1!6406/04*)#1!
!
L$P,(1#!4()$*O/#!!
L$P,(1#!3*$)40#!
L$P,(1#!$)*H/1=*&#!
L/)54H#!6406/04*)#!7H38;!
k:S9!H38!
k:S9H38!
!
L/)54H#!6406/04*)#!*,&#%P#!7H38e38;!
k9SF!
!
!
.)4&*#,$!3(W#,!733>+;!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
!cB9!33>+w!
!c:9!33>+ww!
xC33>+!
R*$#11#!34%!&/!f#$!
cBS9!3e1w!
!
!
"'*,&#%!&#!=#)3P4X*0*$P!!
k9S8C!
!
!
wM2#d!0#1!=4$*#,$1!4W4,$!/,!&PX*$!H4)&*4O/#!#$!/,!&PX*$!$)4,16406/04*)#!,()340!
ww!M2#d!0#1!=4$*#,$1!#,!)W$23#!1*,/140S!Q!*,$#)=)P$P)!#,!5(,H$*(,!&#!04!5)PO/#,H#!H4)&*4O/#!
!
!
U4X0#4/!C!-!!
M)*$N)#1!PH2(+)4=2*O/#1!=(/)!&P5*,*)!04!1P6P)*$P!&#1!)P+/)+*$4$*(,1!6406/04*)#1!-!!
!
^P+/)+*$4$*(,!4()$*O/#!!
^P+/)+*$4$*(,!3*$)40#!
^P+/)+*$4$*(,!
$)*H/1=*&#!
u/40*$4$*6#!!
!
!
!
_()=2(0(+*#!&#!04!
6406#!
Q,()340e!=)(04=1/1!
H(3=0#$e!&#5#H$!&#!
H(4=$4$*(,!04)+#4!
=)(04=1/1!H(3=0#$!&'/,!
5#/*00#$!6406/04*)#e)/=$/)#!&/!
3/1H0#!=4=*004*)#e&#5#H$!&#!
H(4=$4$*(,!04)+#!
Q,()340e!=)(04=1/1!
H(3=0#$!e&#5#H$!&#!
H(4=$4$*(,!04)+#4!
?#$!)P+/)+*$4,$!4/!
&(==0#)!H(/0#/)!
+)4,&!#,!H41!&#!f#$!
H#,$)40A!64)*4X0#!#,!H41!
&#!f#$!#%H#,$)P!
!
$)N1!+)4,&!f#$!H#,$)40!(/!f#$!
#%H#,$)P!4&2P)#,$!#$!
1'#,)(/04,$!T!04!=4)(*!#$!
4$$#*+,4,$!0#!5(,&!&#!
0'()#*00#$$#!+4/H2#!
$)N1!+)4,&!f#$!H#,$)40!
(/!f#$!#%H#,$)P!
2#/)$4,$!04!=4)(*!
!
?#$!)P+/)+*$4,$!4/!
&(==0#)!H(,$*,/!
Z#,1#!
Z#,1#e$)*4,+/04*)#!
Z#,1#e$)*4,+/04*)#!
46#H!/,!=*H!4/!&PX/$!!
76*$#11#!k8!3e1!&4,1!
0'GU!3411*6#;!
Q/$)#1!
R*$#11#!$P0P!&*41$(0*O/#!
H)(11#!4()$*O/#!c89!
H3e1!
o(,#!&#!H(,6#)+#,H#!04)+#4!
!
Attention+:+pour+faciliter+la+présentation,+la+lettre+majuscule+exprimant+le+niveau+de+preuve+est+
collée+à+la+classe+de+recommandation.+Ex+:+une+recommandation+de+classe+IIa+avec+un+niveau+de+
preuve+A,+sera+exprimée+sous+la+forme+IIaA.+