2014 valvular heart disease guidelines feature a new 4-stage classification that goes from “at risk” to “progressive” to “asymptomatic severe” to “symptomatic severe”. A risk assessment scheme is included for intervention or surgery. Transcatheter aortic valve implantation (TAVI) is addressed for the first time and is recommended for patients who are not candidates for surgery and would be expected to survive longer than a year after an intervention. For patients who have an indication for aortic valve replacement and a high surgical risk, TAVI is considered as a reasonable alternative to surgery.2014心瓣膜病指南采用新的4级分类,从“有风险”,“进展型”,“无症状重型”逐步发展到“有症状重型”。指南中包括介入或手术的风险评估方案。经导管主动脉瓣植入术(TAVI)是第一次在指南中提出,建议用于不适合手术且预估介入后生存期超过一年的病人。对于有主动脉瓣置换术指征而手术风险高的患者,TAVI可做为一个合理的手术替代措施。
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