《经导管主动脉瓣置换术中国专家共识(2020更新版)》解读.pdfVIP

《经导管主动脉瓣置换术中国专家 共识（2020 更新版）》解读 党梦秋 范嘉祺 朱齐丰 郭宇超 刘先宝 王建安 [摘要] 经导管主动脉瓣置换术（TAVR）目前已经成为老年主动脉瓣狭窄（AS）患者的主要治疗方式。《经导管主动脉瓣置 换术中国专家共识（2020 更新版）》在 2015 年《经导管主动脉瓣置换术中国专家共识》的基础上，对 TAVR 手术的术前筛查、术 中操作及术后患者的管理等方面进行了更为详细的补充和阐述，为我国 TAVR 手术的规范开展提供强有力的依据。本文将结合 TAVR 的最新研究进展从以下方面对该专家共识进行解读 ：（1）我国 AS 的流行病学特点不同于西方国家，风湿性心脏瓣膜病 及二叶式主动脉瓣（BAV）是我国 AS 的主要病因；（2）将外科手术中低危 AS 患者（年龄 ≥70 岁）纳入 TAVR 术相对适应证；（3 ） 对 TAVR 术中球囊扩张 、快速起搏频率及瓣膜置入深度进行更加详细及 明确的阐释；（4 ）增加 了关于 TAVR 术后抗栓方案的建 议；（5）增加了针对合并冠心病、肾功能不全等情况以及急诊 TAVR 术的处理意见。 [关键词] 经导管主动脉瓣置换术 主动脉瓣狭窄 风湿性心脏瓣膜病 二叶式主动脉瓣 Interpretation of consensus of Chinese experts on transcatheter aortic valve replacement (2020 update) DANG Mengqiu, FAN Jiaqi, ZHU Qifeng, GUO Yuchao, LIU Xianbao, WANG Jianan. Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou310009, China Corresponding author: WANG Jianan ，E-mail ：wangjianan111@zju.edu.cn [Abstract] Transcatheter aortic valve replacement (TAVR) has become the main treatment for Aortic Stenosis(AS) in elderly patients. The consensus of Chinese experts on transcatheter aortic valve replacement (2020 update) elaborates in the fields of screening before procedures, intraoperative procedures and management post-procedures in details, which promotes the development of TAVR in our country. This article will interpret the expert consensus based on the latest research of TAVR from the following aspects: (1) The epidemiological characteristics of AS in China are different from those in Western countries. Rheumatic heart valve disease and bicuspid aortic valve (Bicuspid aortic valve, BAV) are the main cause of AS in China; (2) The relative indications of TAVR includesthe AS patients at low-risk (age ≥70 years) forsurgical valve replacement; (3) More comprehensive and specificstatement are updated for balloon dilatation, rapid p