RAN Zechao 1,2 , WANG Yuqiang 1,2 , HE Siyu 1,2 , ZHONG Shitong 1,2 , CAO Tingqian 3 , LIU Xiang 4 , LUO Zeruxin 5 , LIU Lulu 1 , SHI Jun 1 , GUO Yingqiang 1,2
  • 1. Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
  • 2. Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
  • 3. Integrated Care Management Center, Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
  • 4. Information Technology Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
  • 5. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
GUO Yingqiang, Email: drguoyq@wchscu.cn
Valvular heart disease; whole life cycle management model; disease management specialist; health services
10.7507/1007-4848.202503026
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Objective  To address the "three-low predicament" in China’s valvular heart disease (VHD) diagnosis and treatment system (low detection rate, low intervention rate, and low follow-up rate), and to propose and implement a whole life cycle management model for VHD considering the increasing burden of degenerative valvular disease in the context of an aging population. Methods  Since 2020, West China Hospital of Sichuan University has established a management system encompassing "assessment-decision-intervention-follow-up", including: (1) a risk-stratified, tiered management pathway; (2) six core functions ("promotion, screening, prevention, diagnosis, treatment, and rehabilitation") coordinated by disease-specific managers; (3) an intelligent decision support information platform; and (4) a collaborative network of multidisciplinary teams and regional academic alliances. Results  Between 2020 and 2024, a total of 583 874 individuals underwent echocardiographic screening. A total of 48 089 patients with aortic valve disease were identified, including 3 401 (7.1%) high-risk patients, 18 657 (38.8%) moderate-risk patients, and 26 031 (54.1%) low-risk patients. Among them, 2 417 patients were enrolled in whole life cycle management. Patient satisfaction scores showed a yearly increase, rising from 73.89 points before 2020 to 93.74 points in 2024. The 1-year mortality rate in the transcatheter aortic valve replacement cohort decreased to 5.3%, significantly lower than the 8.2% observed under early standard management between 2014 and 2019 (P<0.01). Conclusion  The VHD whole life cycle management model, through optimized processes and integrated resources, has achieved significant results in standardizing diagnosis and follow-up procedures, improving patient satisfaction and quality of life, and reducing mortality. It provides a scalable practical model for VHD management in China.

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