AHAACC瓣膜病指南TAVI_培训课件.pptx

2014 AHA/ACC瓣膜病指南解读与我国经导管主动脉瓣置入术（TAVI）发展现状国家心血管病中心阜外心血管病医院吴永健2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展人口老龄化，瓣膜性心脏病（VHD）随年龄增长发病率增加，给社会造成巨大负担2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展背景Euro Heart Survey中VHD分布情况老年型钙化性主动脉瓣疾病（CAVD）的发病率呈现上升趋势，成为仅次于冠心病和高血压的心血管疾病。目前最常见的VHD为钙化性AS和MR，AR和MS变得相对少见2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展背景Euro Heart Survey单瓣膜病的病因分析我国一项回顾性非随机研究分析提示50岁以上的的中老年患者主动脉瓣钙化(AVC)的发病率达49.38%。随着人口的老龄化，钙化性主动脉瓣狭窄（CAS）的发病率增加，即将成为我国瓣膜病的首要病因。2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展TitleOrganizationPublication YearRecommendations for Evaluation of the Severity of Native Valvular Regurgitation With Two-Dimensional and Doppler Echocardiography ASE2003 Guidelines for the Management of Patients With Atrial Fibrillation ACC/AHA/ESC2006 Guidelines for the Management of Adults With Congenital Heart Disease ACC/AHA2008 Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice EAE/ASE2009 Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound ASE2009 Guideline for the Diagnosis and Treatment of Hypertrophic CardiomyopathyACCF/AHA2011 Guidelines on the Management ofCardiovascular Diseases During Pregnancy ESC2011 Antithrombotic and Thrombolytic Therapy for Valvular Disease： Antithrombotic Therapy and Prevention of Thrombosis ACCP2012 Guidelines on the Management of Valvular HeartESC/EACTS2012 Guideline for the Management of Heart FailureACCF/AHA2013 ACC indicates American College of Cardiology; ACCF, American College of Cardiology Foundation; ACCP, American College of Chest Physicians; AF, atrial fibrillation; AHA, American Heart Association; ASE, American Society of Echocardiography; EACTS, European Association of Cardio Thoracic Surgery; EAE, European Association of Echocardiography; ESC, European Society of Cardiology; and VHD, valvular heart disease. 2014 AHA/ACC瓣膜病指南解读我国TAVI最新进展2012年ESC年会时，首次由ESC和EACTS共同制定完成的心脏瓣膜病管理指南发布，指南首次明确了TAVI指征。2014年3月AHA/ACC专家协同AATS、ASE、SCAI、SCA和STS等协会专