Yap Jonathan, Hayashida Kentaro, Lee Michael Kang Yin, Stub Dion, Hon Jimmy Kim Fatt, Ho Kay Woon, Lo Sidney, Seth Ashok, Kim Hyo-Soo, Wongpraparut Nattawut, Nguyen Quang Ngoc, Dy Timothy C, Chandavimol Mann, Ewe See Hooi, Yin Wei-Hsian, Lee Yung-Tsai, Tay Edgar L, Poon Karl, Chen Mao, Chui Angus, Lam Simon Cheung-Chi, Rao Ravinder Singh, Izumo Masaki, Nair Rajesh, Tang Gilbert Hl, Tabata Minoru, Yahaya Shaiful Azmi, Sin Kenny Yk, Park Duk-Woo, Wang Jianan, Chieh Jack Tan Wei
Department of Cardiology, National Heart Centre Singapore, Singapore.
Duke-NUS Medical School, Singapore.
JACC Asia. 2024 Nov 1;4(12):885-897. doi: 10.1016/j.jacasi.2024.10.001. eCollection 2024 Dec.
Transcatheter aortic valve implantation (TAVI) has been established as an effective treatment modality in patients with severe aortic stenosis (AS) and the uptake of TAVI is rapidly growing in the Asia-Pacific region. However, there exist a heterogeneity in the management of aortic stenosis and the use of TAVI among countries in the region. Reasons for these differences include anatomic variations, disparity in healthcare resources and infrastructure, and the lack of consensus on the optimal management of AS in the Asia-Pacific region. Hence, an Asian Pacific Society of Cardiology (APSC) working group, including a multidisciplinary group of general and interventional cardiologists, cardiac surgeons, imaging specialists, developed a position statement on the recommendations for TAVI in the management of aortic stenosis. The APSC expert panel reviewed and appraised the available evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Recommendations were developed and put to an online vote. Consensus was reached when 80% of votes for a given recommendation were in support of "agree" or "neutral." The resulting 28 statements provide guidance for clinical practitioners in the region on the use of TAVI in the treatment of patients with aortic stenosis.
经导管主动脉瓣植入术(TAVI)已被确立为重度主动脉瓣狭窄(AS)患者的一种有效治疗方式,且在亚太地区,TAVI的应用正在迅速增长。然而,该地区各国在主动脉瓣狭窄的管理及TAVI的使用方面存在异质性。这些差异的原因包括解剖学变异、医疗资源和基础设施的差异,以及亚太地区在AS最佳管理方面缺乏共识。因此,一个由普通心脏病专家、介入心脏病专家、心脏外科医生、影像专家组成的多学科团队——亚太心脏病学会(APSC)工作组,就TAVI在主动脉瓣狭窄管理中的推荐制定了一份立场声明。APSC专家小组使用推荐分级评估、制定和评价系统对现有证据进行了审查和评估。制定了相关推荐并进行了在线投票。当某一特定推荐80%的投票支持“同意”或“中立”时,即达成共识。最终得出的28条声明为该地区临床医生在使用TAVI治疗主动脉瓣狭窄患者方面提供了指导。