Dumpies Oliver, Urbschat Marik, Noack Thilo, Abdel-Wahab Mohamed
Department of Cardiology, Heart Center Leipzig, University of Leipzig, Strümpellstraße 39, 04289, Leipzig, Deutschland.
Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Deutschland.
Herz. 2025 Sep 9. doi: 10.1007/s00059-025-05331-z.
Since the earliest studies on transcatheter aortic valve implantation (TAVI), the heart team concept has been an integral component of treatment planning for patients with aortic valve stenosis (AS). The primary objective is to ensure patient-specific, guideline-based treatment through the structured involvement of all relevant medical disciplines. The TAVI heart team is strongly recommended with a class I indication in both European and US clinical guidelines. A TAVI heart team typically consists of interventional cardiologists, cardiac surgeons, anesthesiologists and cardiac imaging specialists and can be supplemented by additional experts depending on the clinical scenario. The team's responsibilities span the entire continuum of care, from diagnostic assessment and procedural planning to complication management and structured follow-up. The concept of lifetime management is gaining importance, aiming for a long-term strategic approach to valve care throughout the patient's lifespan. Given the evolving age boundaries for intervention, an extension of the heart team approach to all patients with AS is warranted. Clearly defined roles, standardized protocols and defined decision-making processes, supported by a dedicated TAVI coordinator, can substantially enhance both efficiency and quality of care. Looking ahead, digital technologies, artificial intelligence and structured upstream screening strategies for asymptomatic AS patients are expected to play an expanding role.
自最早关于经导管主动脉瓣植入术(TAVI)的研究以来,心脏团队理念一直是主动脉瓣狭窄(AS)患者治疗规划的一个组成部分。主要目标是通过所有相关医学学科的结构化参与,确保针对患者个体、基于指南的治疗。在欧洲和美国的临床指南中,强烈推荐成立TAVI心脏团队,其指征为I类。一个TAVI心脏团队通常由介入心脏病学家、心脏外科医生、麻醉师和心脏影像专家组成,并可根据临床情况增加其他专家。该团队的职责涵盖整个护理过程,从诊断评估和手术规划到并发症管理和结构化随访。终身管理的概念正变得越来越重要,旨在对患者整个生命周期的瓣膜护理采取长期的战略方法。鉴于干预的年龄界限不断变化,有必要将心脏团队方法扩展到所有AS患者。在专职TAVI协调员的支持下,明确界定的角色、标准化方案和明确的决策流程可大幅提高护理效率和质量。展望未来,数字技术、人工智能以及针对无症状AS患者的结构化上游筛查策略预计将发挥越来越大的作用。