经导管主动脉瓣置换术的护理.pptxVIP

经导管主动脉瓣置换术 围术期护理（TAVR)心血管内科 CONTENTSTAVR的定义,国内外开展情况TAVR适应症及术前筛选TAVR术中操作规范及术后抗栓治疗并发症的防治手术综合管理及术后康复随访目录 TAVR定义和国内外开展情况 TAVR定义经导管主动脉瓣置换术(Transcatheter Aortic Valve Replacement, TAVR):又称经导管主动脉瓣置入术(Transcatheter Aortic Valve Implantation，TAVI)是指将组装完备的人工主动脉瓣经导管置入到病变主动脉瓣处，在功 能上完成主动脉瓣的置换。 TAVR研究背景自2002年首例成功以来［1 ］, TAVR已成为老年主动脉瓣狭窄 (aortic stenosis,AS)患者的一线治疗手段。欧美国家相继 颁布并更新了TAVR的指导性文件［1 -5］。[1 ] Holmes DR, Mack MJ, Kaul S, et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol, 2012, 59 (13) :[2 ] Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol, 2014, 63 (22) : 2438-2488.[3] Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38 (36) : 2739-2791.[4] Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of theAmerican College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70 (2) : 252-289.[5] Otto CM , Kumbhani DJ, Alexander KP, et al. 2017 ACC expert consensus decision pathway for transcatheter aortic valve replacement in the management of adults with aortic stenosis:a report of the American College of Cardiology task force on clinical expert consensus documents. J Am Coll Cardiol, 2017, 69 (10) : 1313-1346. 全球首例经导管主动脉瓣置换术(Transcatheteraortic aortic valve replacement, TAVR)April 16,2002Cribier等人在法国里 昂进行了人类第一例 经皮带瓣膜支架主动 脉瓣植入术Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic StenosisFirst Human Case DescriptionAlain Cribier, MD; Helene Eltchaninoff, MD; AssafBash, PhD; Nicolas Bor