December 23, 2020 Guidelines for the management of valvular heart disease (VHD) have been refreshed by the American College of Cardiology and American Heart Association—the first full revision since 2014. Most salient among the changes is the inclusion of the pivotal low-risk TAVR trials that led to US Food and Drug Administration approval for that indication last fall. With Catherine M. Otto, MD (University of Washington, Seattle), and Rick A. Nishimura, MD (Mayo Clinic, Rochester, MN), as co-chairs, the multisociety-produced document was published online last week in both Circulation and the Journal of the American College of Cardiology. Patrick T. O’Gara, MD (Brigham and Women’s Hospital, Boston, MA), one of its authors, told TCTMD that, as for any guideline recommendations, what motivated the revision was the “publication of practice-changing science.” Beyond the low-risk TAVR trials, other influential studies included here are COAPT and MITRA-FR, both in the mitral space.