中国经导管二尖瓣缘对缘修复术临床路径(2022精简版)

Clinical pathway for transcatheter mitral valve edge-to-edge repair in China (abbreviated version 2022)

经导管二尖瓣缘对缘修复术(transcatheter mitral valve edge-to-edge repair,TEER)已成为外科手术高危的重度二尖瓣反流(mitral regurgitation,MR)患者的重要治疗选择。其手术流程复杂,团队协作要求高,但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键问题,专家组撰写了此临床路径,以推动我国TEER技术规范、安全地开展和推广普及,促进我国MR患者诊疗水平和生活质量的提升。

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. The devices and procedural techniques of TEER are complex and require excellent team cooperation. However, there is still a lack of standardized clinical pathways in China.Based on the latest evidence, the expert group wrote this clinical pathway to guide and optimize TEER therapy in clinical practice. It demonstrates the following key issues of clinical concern:(1) TEER team building;(2) preoperative clinical evaluation of TEER patients;(3) imaging assessment before TEER procedure;(4) standardized procedures for TEER;(5)TEER for complex MR;(6) the standard process of perioperative comprehensive management;and(7) full life-cycle rehabilitation and follow-up. This clinical pathway might be helpful to facilitate the standardized development of TEER therapy and application, and promote the improvement of management and life quality for patients with MR.