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2012年新版心脏瓣膜疾病(VHD)防治指南在德国慕尼黑ESC大会上由欧洲心脏病协会(ESC)和欧洲心胸外科协会(EACTS)联合发布。指南更新是基于过去5年里新收集到的临床证据,主要变化包括:淡化对EuroSCORE及STS评分的依赖,强调构建心脏团队对患者管理的重要性,明确了经导管主动脉瓣植入术(TAVI)以及经皮缘对缘瓣膜修复术的指针,以及术后抗凝策略的调整等。指南还进一步提示我们:虽然心脏瓣膜病的介入治疗取得了长足的进展,从而使得外科手术不再是某些瓣膜病的惟一治疗方法,但介入治疗仍有许多问题,如适应证的选择、多中心大样本的追踪随访及远期疗效评价、并发症等。在相关条件尚不成熟的大中型医院建议不开展此类诊疗技术。对待新的诊疗技术,我们应该遵循积极探索、谨慎推进的原则,切记冒进。
The 2012 New Guidelines for the Prevention and Treatment of Heart Valve Disease (VHD) were jointly presented by the European Society of Cardiology (ESC) and the European Association of Cardiothoracic Surgeons (EACTS) at the ESC Congress in Munich, Germany. The guide update is based on newly collected clinical evidence over the past five years. Key changes include: Decreasing dependence on EuroSCORE and STS scores, emphasizing the importance of building a cardiac team for patient management, and identifying the role of transcatheter aortic valve implantation TAVI) as well as the percutaneous edge of the valve repair valve, and postoperative anticoagulation strategy adjustment. The guide further reminded us that although there has been considerable progress in the interventional treatment of heart valve disease, surgery has ceased to be the only treatment for some valvular diseases, there are still many problems with interventional procedures, such as indications of choice Follow-up of large sample center and long-term efficacy evaluation, complications and so on. In the relevant conditions are not mature large and medium-sized hospitals do not recommend such treatment technology. To treat the new diagnosis and treatment technology, we should follow the principle of active exploration and prudence, and keep in mind.