经心尖经导管主动脉瓣置换术围术期超声心动图评估规范

Perioperative echocardiographic evaluation standard for transapical transcatheter aortic valve replacement

经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)在我国经过近20年的飞速发展,目前已进入崭新而关键的阶段。TAVR瓣膜种类繁多,各有特色,其手术有经股动脉、经心尖、经颈动脉或经升主动脉多种入路,以前两者较为常见。超声心动图在TAVR围术期起至关重要的作用。相对于经股动脉TAVR,经心尖TAVR在围术期超声心动图观察中有不同的要点,但目前尚缺乏统一标准。为了推进经心尖TAVR安全有效地应用于临床,特制定本规范,重点阐述超声心动图在术前筛选、术中监测和术后随访中的观测内容和技术要点。

Transcatheter aortic valve replacement(TAVR)has entered a new and critical stage after nearly 20years of rapid development in China.There are various types of TAVR valves with different advantages.TAVR can be performed through various approaches such as transfemoral artery,transapical,trans-carotid artery,or trans-ascending aorta.The first two are more common.Echocardiography plays an important role in the perioperative period of TAVR.Compared to transfemoral approach,transapical TAVR has different key points in perioperative echocardiography which is lack of unified and accurate standards.This standard is specially formulated to focus on the key points of echocardiography in preoperative screening,intraoperative monitoring and postoperative follow-up in order to promote the safe and effective application of transapical TAVR in the clinic.