{"id":17018,"date":"2019-04-23T04:51:30","date_gmt":"2019-04-22T20:51:30","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=17018"},"modified":"2019-06-02T06:36:58","modified_gmt":"2019-06-01T22:36:58","slug":"jama%e4%b8%b4%e5%ba%8a%e6%8c%87%e5%8d%97%e6%95%ac%e9%82%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=17018","title":{"rendered":"[JAMA\u4e34\u5e8a\u6307\u5357\u7cbe\u8981]\uff1a\u63a5\u53d7\u7ecf\u5bfc\u7ba1\u74e3\u819c\u7f6e\u6362\u7684\u91cd\u5ea6\u4e3b\u52a8\u8109\u74e3\u72ed\u7a84\u60a3\u8005\u7684\u8bca\u6cbb"},"content":{"rendered":"\n

JAMA Clinical Guidelines Synopsis March 25, 2019<\/h3>\n\n\n\n

Management of Patients With Severe Aortic Stenosis With Transcatheter Valve Replacement<\/h1>\n\n\n\n

AbdulRahman Dia, Adam S. Cifu, Atman P. Shah<\/h3>\n\n\n\n

JAMA. <\/em>2019;321(15):1527-1528. doi:10.1001\/jama.2019.1336<\/h3>\n\n\n\n

Guideline title<\/strong> \u6307\u5357\u6807\u9898<\/h2>\n\n\n\n

2017 AHA\/ACC Focused Update of the 2014 AHA\/ACC Guideline for the Management of Patients With Valvular Heart Disease<\/p>\n\n\n\n

2014 AHA\/ACC \u5fc3\u810f\u74e3\u819c\u75c5\u60a3\u8005\u8bca\u6cbb\u6307\u5357\u76842017\u9488\u5bf9\u6027\u66f4\u65b0<\/p>\n\n\n\n

Release date<\/strong> \u53d1\u5e03\u65e5\u671f<\/h2>\n\n\n\n

June 20, 2017<\/p>\n\n\n\n

Developers<\/strong> \u5236\u8ba2\u8005<\/h2>\n\n\n\n

American College of Cardiology (ACC)\/American Heart Association (AHA)<\/p>\n\n\n\n

Funding sources<\/strong> \u8d44\u91d1\u6765\u6e90<\/h2>\n\n\n\n

ACC and AHA<\/p>\n\n\n\n

Target population<\/strong> \u76ee\u6807\u4eba\u7fa4<\/h2>\n\n\n\n

Adult patients with severe aortic stenosis<\/p>\n\n\n\n

\u4e3b\u52a8\u8109\u74e3\u91cd\u5ea6\u72ed\u7a84\u7684\u6210\u5e74\u60a3\u8005<\/p>\n\n\n\n

Major recommendations and ratings<\/strong> \u4e3b\u8981\u63a8\u8350\u610f\u89c1\u53ca\u7ea7\u522b<\/h2>\n\n\n\n
  • Among patients for whom transcatheter valve replacement (TAVR) or high-risk surgical aortic valve replacement (SAVR) is being considered, a heart valve team should establish a management plan (strong recommendation; level of evidence, C [based on limited studies]). \u5bf9\u4e8e\u8003\u8651\u8fdb\u884cTAVR\u6216\u9ad8\u5371\u4e3b\u52a8\u8109\u74e3\u7f6e\u6362\u5916\u79d1\u624b\u672f(SAVR)\u7684\u60a3\u8005\uff0c\u5fc3\u74e3\u819c\u56e2\u961f\u5e94\u5f53\u5236\u5b9a\u8bca\u7597\u8ba1\u5212\uff08\u5f3a\u63a8\u8350\uff1b\u8bc1\u636e\u7ea7\u522b\uff0cC [\u57fa\u4e8e\u6709\u9650\u7814\u7a76]\uff09]<\/li>
  • Surgical AVR or TAVR is recommended for symptomatic patients with severe aortic stenosis and at high risk (strong recommendation; level of evidence, A [benefit strongly exceeds risk based on long-term outcomes from multiple randomized clinical trials {RCTs}]). \u63a8\u8350\u5916\u79d1AVR\u6216TAVR\u7528\u4e8e\u6709\u4e34\u5e8a\u75c7\u72b6\u7684\u91cd\u5ea6\u4e3b\u52a8\u8109\u74e3\u72ed\u7a84\u53ca\u9ad8\u5371\u60a3\u8005\uff08\u5f3a\u63a8\u8350\uff1b\u8bc1\u636e\u7ea7\u522b\uff0cA [\u57fa\u4e8e\u591a\u4e2aRCTs\u7684\u957f\u671f\u9884\u540e\uff0c\u83b7\u76ca\u8fdc\u8d85\u98ce\u9669]\uff09<\/li>
  • Transcatheter AVR is recommended for symptomatic patients with severe aortic stenosis and a prohibitive risk for SAVR who have a predicted post-TAVR survival greater than 12 months (strong recommendation; level of evidence, A [based on long-term outcomes from multiple RCTs]). \u7ecf\u5bfc\u7ba1AVR\u63a8\u8350\u7528\u4e8e\u6709\u4e34\u5e8a\u75c7\u72b6\u7684\u91cd\u5ea6\u4e3b\u52a8\u8109\u74e3\u72ed\u7a84\u53ca\u6709SAVR\u7981\u5fcc\u75c7\u4e14\u9884\u671fTAVR\u540e\u5b58\u6d3b\u8d85\u8fc712\u4e2a\u6708\u7684\u60a3\u8005\uff08\u5f3a\u63a8\u8350\uff1b\u8bc1\u636e\u7ea7\u522b\uff0cA [\u57fa\u4e8e\u591a\u4e2aRCTs\u7684\u957f\u671f\u9884\u540e]\uff09<\/li>
  • Transcatheter AVR is a reasonable alternative to SAVR for symptomatic patients with severe aortic stenosis and an intermediate surgical risk (moderate recommendation; level of evidence, B-R [limited populations studied in RCTs]). \u5bf9\u4e8e\u6709\u4e34\u5e8a\u75c7\u72b6\u7684\u91cd\u5ea6\u4e3b\u52a8\u8109\u74e3\u72ed\u7a84\u4e14\u6709\u5373\u523b\u624b\u672f\u98ce\u9669\u7684\u60a3\u8005\uff0c\u7ecf\u5bfc\u7ba1AVR\u662f\u5408\u7406\u9009\u62e9\uff08\u4e2d\u7b49\u7a0b\u5ea6\u63a8\u8350\uff1b\u8bc1\u636e\u7ea7\u522b\uff0cB-R [RCTs\u7814\u7a76\u4eba\u7fa4\u6709\u9650]\uff09<\/li>
  • Transcatheter AVR is not recommended in patients for whom life expectancy would preclude the expected benefit from correction of aortic stenosis (strong recommendation; level of evidence, B-R [limited RCTs]). \u7ecf\u5bfc\u7ba1AVR\u4e0d\u63a8\u8350\u7528\u4e8e\u9884\u671f\u751f\u5b58\u8f83\u77ed\uff0c\u65e0\u6cd5\u4ece\u7ea0\u6b63\u4e3b\u52a8\u8109\u74e3\u72ed\u7a84\u83b7\u76ca\u7684\u60a3\u8005\uff08\u5f3a\u63a8\u8350\uff1b\u8bc1\u636e\u7ea7\u522b\uff0cB-R [\u6709\u9650RCTs]\uff09<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"

    JAMA Clinical Guidelines Synopsis March 25, 2019 M […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[25,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/17018"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=17018"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/17018\/revisions"}],"predecessor-version":[{"id":17020,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/17018\/revisions\/17020"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=17018"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=17018"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=17018"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}