经导管主动脉瓣置换术临床实践指南

Chinese guideline for the clincal application of transcatheter aortic valve replacement

经导管主动脉瓣置换术(TAVR)作为国际上治疗主动脉瓣疾病的重要手段,在我国有着起步晚、发展迅速的特点。在临床普及的过程中,由于缺乏标准化的指南及培训,为该技术在我国的推广带来了挑战。为了规范TAVR技术的应用及提高医疗质量,国家心血管病中心及国家结构性心脏病介入质控中心联合中华医学会心血管病学分会及中华医学会胸心血管外科学分会共同成立TAVR临床实践指南联合专家组,结合国际指南推荐意见和中国临床实践现状,整合国内外最新的循证医学证据,在广泛征求意见的基础上制订了《经导管主动脉瓣置换术临床实践指南》。指南包括编写方法、流行病学特点、TAVR器械、心脏团队的要求、TAVR适应证推荐、围手术期多模态影像学评估、手术操作流程、TAVR术后抗栓策略、并发症的防治、术后康复及随访、局限性及展望十一个部分,旨在为各级临床医师提供合理的推荐和建议。

Transcatheter aortic valve replacement(TAVR),as an important procedure for aortic valve diseases worldwide,features with a late start and rapid development in China.In the process of clinical application,the lack of standard guidelines and training system has brought challenges to the widespread use of this technique.In order to standardize the application of TAVR technique and improve the quality of medical care,the National Center for Cardiovascular Diseases and the National Center for Quality Control of Structural Heart Disease Intervention,together with the Chinese Society of Cardiology and the Chinese Society for Thoracic and Cardiovascular Surgery,jointly established an expert group on the guidelines for TAVR,combined with the recommendations of international guidelines and the current clinical practice in China,integrated the latest evidence in China and worldwide to develop the clinical guideline of TAVR with extensive consultation(Chinese Expert Consensus).The guideline mainly included 11 parts:methods,epidemiological feature,TAVR devices,requirements of cardiac teams,recommendations for TAVR indications,perioperative multimodality imaging evaluation,surgical procedures,anti-thrombotic strategies after TAVR,prevention and treatment of complications,postoperative rehabilitation and follow-up,limitations and prospects,aiming to provide reasonable recommendations for all-level clinicians in China.