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Transcatheter Aortic Valve Implantation Outcomes: Implications for Practice

McRae, Marion E. MScN, NP, RN, CCRN-CSC-CMC, ACNP-BC, CCN(C), ACNPC; Rodger, Marnie MN, NP, RN, CCN(C)

Journal of Cardiovascular Nursing: May/June 2012 - Volume 27 - Issue 3 - p 270–282
doi: 10.1097/JCN.0b013e318217d288
Articles

Aortic stenosis is a common valvular pathological finding in older adults. Currently, aortic valve replacement is the gold-standard treatment for severe symptomatic aortic stenosis. However, patients with advanced age and multiple comorbidities carry a significant operative risk. Transcatheter aortic valve implantation (TAVI) was developed with the goal of offering a less invasive alternative to symptomatic high-risk patients with aortic stenosis. Since the first successful TAVI procedure in 2002, TAVI has been used as a treatment option for patients at very high or prohibitive surgical risk in clinical feasibility trials, registries, and in ongoing randomized controlled trials. There are 2 transcatheter valves in widespread clinical application, with several others in different stages of development. This article provides an overview of TAVI outcomes including insertion options, procedural outcomes, morbidity, valve durability, short- to medium-term survival, and quality of life to guide nursing care interventions. Enhancing nurses’ knowledge of the risks, benefits, and potential complications of TAVI will empower nurses in their role as patient advocates and educators and improve patient outcomes. Gaps in the current TAVI research literature are identified.

Marion E. McRae, MScN, NP, RN, CCRN-CSC-CMC, ACNP-BC, CCN(C), ACNPC Nurse Practitioner, Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Adjunct Clinical Faculty, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada.

Marnie Rodger, MN, NP, RN, CCN(C) Nurse Practitioner, Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Canada.

The authors have no funding or conflicts of interest to disclose.

Correspondence Marion E. McRae, MScN, NP, RN, CCRN-CSC-CMC, ACNP-BC, CCN(C), ACNPC, Toronto General Hospital, 585 University Ave, NCSB-4B-453, Toronto, Canada, M5G2N2 ( marion.mcrae@uhn.on.ca).

© 2012 Lippincott Williams & Wilkins, Inc.