Interpretation of <i>2024 Expert Consensus on Clinical Pathway for Transcatheter Aortic Valve Replacement in China</i>_West China Medical Journal

Authors：

LIU Xinmin , FAN Siyang ,  SONG Guangyuan

Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding author：

SONG Guangyuan, Email: songgy_anzhen@vip.163.com

Keywords：

Transcatheter aortic valve replacement; clinical pathway; expert consensus; interpretation

DOI：

10.7507/1002-0179.202510027

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Since its first clinical application in 2002, transcatheter aortic valve replacement (TAVR) has grown from an exploratory technology to the cornerstone of the treatment of aortic valve disease. The release of 2024 Expert Consensus on Clinical Pathway for Transcatheter Aortic Valve Replacement in China marks a new phase of high-quality development for TAVR in China. This article will thoroughly interpret this programmatic document, comprehensively analyze its key links such as the basis of evidence-based medicine, preoperative clinical evaluation, perioperative imaging evaluation, standardized surgical process, perioperative comprehensive management and postoperative rehabilitation follow-up, explain its clinical path, provide comprehensive guidance for clinical practice, and help the majority of cardiovascular interventional physicians to move forward accurately in the new era of structural heart disease treatment.

1.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
2.	中华医学会心血管病学分会结构性心脏病学组, 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识. 中国循环杂志, 2018, 33(12): 1162-1169.
3.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021 版). 中国循环杂志, 2022, 37(1): 12-23.
4.	中国医师协会心血管内科医师分会结构性心脏病学组, 亚太结构性心脏病俱乐部, 宋光远, 等. 中国经导管主动脉瓣置换术临床路径专家共识(2024 版). 中国循环杂志, 2024, 39(11): 1041-1057.
5.	Thyregod HGH, Jørgensen TH, Ihlemann N, et al. Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial. Eur Heart J, 2024, 45(13): 1116-1124.
6.	Généreux P, Schwartz A, Oldemeyer JB, et al. Transcatheter aortic-valve replacement for asymptomatic severe aortic stenosis. N Engl J Med, 2025, 392(3): 217-227.
7.	Banovic M, Putnik S, Penicka M, et al. Aortic valve replacement versus conservative treatment in asymptomatic severe aortic stenosis: the AVATAR trial. Circulation, 2022, 145(9): 648-658.
8.	Loganath K, Craig NJ, Everett RJ, et al. Early intervention in patients with asymptomatic severe aortic stenosis and myocardial fibrosis: the EVOLVED randomized clinical trial. JAMA, 2025, 333(3): 213-221.
9.	Richardson C, Gilbert T, Aslam S, et al. Rationale and design of the early valve replacement in severe asymptomatic aortic stenosis trial. Am Heart J, 2024, 275: 119-127.
10.	Faza NN, Harb SC, Wang DD, et al. Physical and computational modeling for transcatheter structural heart interventions. JACC Cardiovasc Imaging, 2024, 17(4): 428-440.
11.	Haghiashtiani G, Qiu K, Zhingre Sanchez JD, et al. 3D printed patient-specific aortic root models with internal sensors for minimally invasive applications. Sci Adv, 2020, 6(35): eabb4641.
12.	Sinning JM, Stundl A, Pingel S, et al. Pre-procedural hemodynamic status improves the discriminatory value of the aortic regurgitation index in patients undergoing transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2016, 9(7): 700-711.
13.	Yan Y, Yao J, Yuan F, et al. Single femoral artery access is safe and feasible during transcatheter aortic valve replacement: a propensity score matched analysis. Front Cardiovasc Med, 2023, 10: 1228258.
14.	宋光远, 刘新民, 姚晶, 等. Chimney 支架技术联合 All in One 技术在经导管主动脉瓣置换术中应用的初步经验. 中国循环杂志, 2023, 38(3): 312-317.
15.	Rodés-Cabau J, Ellenbogen KA, Krahn AD, et al. Management of conduction disturbances associated with transcatheter aortic valve replacement: JACC Scientific Expert Panel. J Am Coll Cardiol, 2019, 74(8): 1086-1106.
16.	Chang S, Jiang Z, Liu X, et al. Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study. EClinicalMedicine, 2024, 72: 102603.
17.	Yao J, Lu ZN, Modine T, et al. Evaluation of the safety and efficacy of a novel anatomical classification and dUal anchoRing theory to optimize the TAVR strategy for pure severe aortic regurgitation (AURORA): a prospective cohort study. BMC Cardiovasc Disord, 2022, 22(1): 445.
18.	Yu FC, Peng XP, Yao J, et al. Transcatheter aortic valve implantation in pure aortic regurgitation: one-year outcomes of the AURORA trial. EuroIntervention, 2025, 21(16): 952-960.
19.	Yang L, Chen S, Zhang X, et al. Comparisons of noncoronary sinus pivot implantation (NCPI) and conventional method for transcatheter aortic valve replacement with self-expanding valve in pure aortic regurgitation (PAR). Catheter Cardiovasc Interv, 2024, 103(7): 1093-1100.
20.	Liu R, Li Y, Zhang L, et al. Rationale and design of the CREATE trial: a multicenter, randomized comparison of continuation or cessation of single antithrombotic therapy at 1 year after transcatheter aortic valve replacement. J Am Heart Assoc, 2025, 14(7): e039350.

1. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
2. 中华医学会心血管病学分会结构性心脏病学组, 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识. 中国循环杂志, 2018, 33(12): 1162-1169.
3. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021 版). 中国循环杂志, 2022, 37(1): 12-23.
4. 中国医师协会心血管内科医师分会结构性心脏病学组, 亚太结构性心脏病俱乐部, 宋光远, 等. 中国经导管主动脉瓣置换术临床路径专家共识(2024 版). 中国循环杂志, 2024, 39(11): 1041-1057.
5. Thyregod HGH, Jørgensen TH, Ihlemann N, et al. Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial. Eur Heart J, 2024, 45(13): 1116-1124.
6. Généreux P, Schwartz A, Oldemeyer JB, et al. Transcatheter aortic-valve replacement for asymptomatic severe aortic stenosis. N Engl J Med, 2025, 392(3): 217-227.
7. Banovic M, Putnik S, Penicka M, et al. Aortic valve replacement versus conservative treatment in asymptomatic severe aortic stenosis: the AVATAR trial. Circulation, 2022, 145(9): 648-658.
8. Loganath K, Craig NJ, Everett RJ, et al. Early intervention in patients with asymptomatic severe aortic stenosis and myocardial fibrosis: the EVOLVED randomized clinical trial. JAMA, 2025, 333(3): 213-221.
9. Richardson C, Gilbert T, Aslam S, et al. Rationale and design of the early valve replacement in severe asymptomatic aortic stenosis trial. Am Heart J, 2024, 275: 119-127.
10. Faza NN, Harb SC, Wang DD, et al. Physical and computational modeling for transcatheter structural heart interventions. JACC Cardiovasc Imaging, 2024, 17(4): 428-440.
11. Haghiashtiani G, Qiu K, Zhingre Sanchez JD, et al. 3D printed patient-specific aortic root models with internal sensors for minimally invasive applications. Sci Adv, 2020, 6(35): eabb4641.
12. Sinning JM, Stundl A, Pingel S, et al. Pre-procedural hemodynamic status improves the discriminatory value of the aortic regurgitation index in patients undergoing transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2016, 9(7): 700-711.
13. Yan Y, Yao J, Yuan F, et al. Single femoral artery access is safe and feasible during transcatheter aortic valve replacement: a propensity score matched analysis. Front Cardiovasc Med, 2023, 10: 1228258.
14. 宋光远, 刘新民, 姚晶, 等. Chimney 支架技术联合 All in One 技术在经导管主动脉瓣置换术中应用的初步经验. 中国循环杂志, 2023, 38(3): 312-317.
15. Rodés-Cabau J, Ellenbogen KA, Krahn AD, et al. Management of conduction disturbances associated with transcatheter aortic valve replacement: JACC Scientific Expert Panel. J Am Coll Cardiol, 2019, 74(8): 1086-1106.
16. Chang S, Jiang Z, Liu X, et al. Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study. EClinicalMedicine, 2024, 72: 102603.
17. Yao J, Lu ZN, Modine T, et al. Evaluation of the safety and efficacy of a novel anatomical classification and dUal anchoRing theory to optimize the TAVR strategy for pure severe aortic regurgitation (AURORA): a prospective cohort study. BMC Cardiovasc Disord, 2022, 22(1): 445.
18. Yu FC, Peng XP, Yao J, et al. Transcatheter aortic valve implantation in pure aortic regurgitation: one-year outcomes of the AURORA trial. EuroIntervention, 2025, 21(16): 952-960.
19. Yang L, Chen S, Zhang X, et al. Comparisons of noncoronary sinus pivot implantation (NCPI) and conventional method for transcatheter aortic valve replacement with self-expanding valve in pure aortic regurgitation (PAR). Catheter Cardiovasc Interv, 2024, 103(7): 1093-1100.
20. Liu R, Li Y, Zhang L, et al. Rationale and design of the CREATE trial: a multicenter, randomized comparison of continuation or cessation of single antithrombotic therapy at 1 year after transcatheter aortic valve replacement. J Am Heart Assoc, 2025, 14(7): e039350.

West China Medical Journal

Latest ArticlesInterpretation of 2024 Expert Consensus on Clinical Pathway for Transcatheter Aortic Valve Replacement in China

Abstract Full text Figures/Tables Video References Cited by

Format

Content