中国经导管二尖瓣缘对缘修复术临床路径(2022版)精简版

Clinical Pathway for Transcatheter Mitral Valve Edge-to-edge Repair in China(2022 Edition)

经导管二尖瓣缘对缘修复术(TEER)已成为外科手术高危的重度二尖瓣反流患者的重要治疗选择,TEER的手术流程复杂,团队协作要求高,在中国尚缺乏规范的临床路径。基于当前循证医学证据,针对TEER团队建设、患者临床评估、影像评估、手术规范流程、复杂病变处理、围术期管理、全生命周期康复随访等临床关注的关键问题,专家组有针对性撰写了此临床路径,以推动我国TEER安全、规范地开展和普及,进而提高我国二尖瓣反流的诊疗水平以及改善患者预后。

Transcatheter mitral valve edge-to-edge repair(TEER)has become an important treatment opinion for patients with severe mitral regurgitation(MR)at high risk for surgery.TEER is going through a key stage of rapid development in China.TEER involves complex devices and procedural techniques and requires excellent team collaboration.However,there is still a lack of a standardized clinical pathway for TEER in China.Based on the latest evidence,the expert group wrote this clinical pathway to guide and optimize TEER therapy in clinical practice.It includes the following key issues in terms of clinical concern:(1)TEER team building;(2)Preoperative clinical evaluation of patients suitable for TEER;(3)Imaging assessment before TEER procedure;(4)Standardized procedures for TEER;(5)TEER for complex MR;(6)The standard process of comprehensive perioperative management;and(7)Full life-cycle rehabilitation and follow-up.This clinical pathway might facilitate the standardized development and application of TEER in China,and improve the management of patients with severe MR treated with TEER,thereby enhancing their quality of life.