Transcatheter Aortic Valve Implantation Options For Treating Severe Aortic Stenosis in the Elderly: The Nurses Role in Postoperative Monitoring and Treatment

Panos, Angela M. MSN, CCRN, ACNP-BC; George, Elisabeth L. PhD, RN

Dimensions of Critical Care Nursing: March/April 2014 - Volume 33 - Issue 2 - p 49–56
doi: 10.1097/DCC.0000000000000023
Clinical DIMENSION

Severe calcific aortic stenosis (AS) is a progressive cardiac disease that predominantly affects elderly adults. The hallmark symptoms of AS include exertional dyspnea, angina, and syncope. Adults of advanced age do not usually seek treatment for symptoms until their quality of life is greatly diminished. The 2 standard treatments for severe AS are open aortic valve replacement and percutaneous valvuloplasty. As adults age, their comorbid medical conditions often make them too high of a surgical risk for traditional aortic valve replacement, and percutaneous valvuloplasty, although less invasive, often produces only temporary relief of AS symptoms. To provide severe AS patients with alternative less risky treatment options in their later years, transcatheter aortic valve implantation (TAVI) devices were developed. Through this overview of the disease progression of AS and the different TAVI devices and the insertion procedures, a better understanding of the initial postoperative nursing care associated with postoperative TAVI patient management will be achieved.

Severe calcific aortic stenosis (AS) is a progressive cardiac disease that predominantly affects elderly adults. Transcatheter aortic valve implantation (TAVI) may provide an alternative for many patients. This overview of disease progression and discussion of different TAVI devices and insertion procedures provide information for nurses caring for patients with AS.

Angela M. Panos, MSN, CCRN, ACNP-BC, is a certified registered nurse practitioner with the UPMC Presbyterian-Shadyside Heart and Vascular Institute Department of Cardiothoracic Surgery in Pittsburgh, Pennsylvania. She earned her master’s of science in nursing degree from the Acute Care Nurse Practitioner Program at the University of Pittsburgh.

Elisabeth L. George, PhD, RN, is a clinical nurse specialist in critical care at UPMC Presbyterian Hospital in Pittsburgh, Pennsylvania. Her current focus is fostering the incorporation of evidence-based practice into all aspects of nursing care at UPMC Presbyterian.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Address correspondence and reprint requests to: Angela M. Panos, MSN, CCRN, ACNP-BC, 137 Glo Min Drive, Pittsburgh, PA 15241 ( eapanos@verizon.net).

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