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1.
Nursing ; 49(6): 24-31, 2019 Jun.
Article in English | MEDLINE | ID: mdl-31124850

ABSTRACT

Transcatheter aortic valve replacement (TAVR) is indicated in some patients with severe aortic stenosis for whom surgical intervention is not deemed appropriate. This article explores when TAVR may be the preferred treatment option over surgical aortic valve replacement and discusses various prosthetic valve devices. The TAVR procedure, diagnostic screenings, complications, postoperative management, and nursing considerations are also outlined.


Subject(s)
Aortic Valve Stenosis/nursing , Transcatheter Aortic Valve Replacement/nursing , Aortic Valve , Heart Valve Prosthesis , Humans , Mass Screening/nursing , Nursing Diagnosis , Postoperative Care/nursing , Severity of Illness Index , Transcatheter Aortic Valve Replacement/adverse effects
2.
Healthc Manage Forum ; 29(3): 126-30, 2016 May.
Article in English | MEDLINE | ID: mdl-27060802

ABSTRACT

Transcatheter Aortic Valve Implantation (TAVI) is an innovative and resource-intensive treatment of valvular heart disease. Growing evidence and excellent outcomes are contributing to increased patient demand. The Heart Team is foundational to TAVI programs to manage the complexities of case selection and other aspects of care. The competencies and expertise of nurses are well suited to provide administrative and clinical leadership within the TAVI Heart Team to promote efficient, effective, and sustainable program development. The contributions of nursing administrative and clinical leaders exemplify the leadership roles that nurses can assume in healthcare innovation.


Subject(s)
Aortic Valve Stenosis/surgery , Leadership , Patient Care Team/organization & administration , Transcatheter Aortic Valve Replacement/nursing , Aortic Valve Stenosis/nursing , Cardiac Catheterization , Heart Valve Prosthesis Implantation/nursing , Humans , Risk Factors , Treatment Outcome
3.
Hu Li Za Zhi ; 62(3): 78-82, 2015 Jun.
Article in Zh | MEDLINE | ID: mdl-26073960

ABSTRACT

Aortic stenosis has a high prevalence among individuals over 75 years of age. Transcatheter aortic valve implantation (TAVI) is a novel valve-replacement technique for patients with multiple chronic diseases who are at high risk of requiring aortic valve replacement surgery. Most of the time, the indicators of TAVI are detected during an echocardiographic exam. The femoral artery is the primary insertion site. The complications of TAVI include stroke, vascular dissection, bleeding, aortic valve regurgitation, and arrhythmia. In terms of clinical effectiveness, the mortality rate of TAVI is lower than percutaneous ballon valvuloplasty but similar to AVR. The unplanned cardiac-related re-admission rate within 30 days of discharge is lower for TAVI than for AVR. In terms of activity tolerance, TAVI is significantly better than both percutaneous ballon valvuloplasty and AVR. Comprehensive nursing care may reduce the incidence of complications associated with TAVI. Nursing care of TAVI includes explaining and providing instructions regarding TAVI prior to the procedure. After the TAVI procedure and while the patient is in the ICU, remove the endotracheal tube as soon as possible, monitor his / her neuro-cognitive status, monitor for early detection of a stroke event, record urine output to assess renal function, observe bleeding in the puncture site, and evaluate cardiac arrhythmia and pain. While in the general ward, resume early physical activities and educate the patient regarding the risks and the prevention of bleeding. This article provides references for clinical staff responsible to care for post-TAVI surgery patients.


Subject(s)
Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Transcatheter Aortic Valve Replacement/methods , Transcatheter Aortic Valve Replacement/nursing
4.
J Am Geriatr Soc ; 69(5): 1377-1387, 2021 05.
Article in English | MEDLINE | ID: mdl-33730373

ABSTRACT

BACKGROUND/OBJECTIVES: Older patients admitted to cardiac care units often suffer functional decline. We evaluated whether a nurse-led geriatric co-management program leads to better functional status at hospital discharge. DESIGN: A quasi-experimental before-and-after study was performed between September 2016 and December 2018, with the main endpoint at hospital discharge and follow-up at 6 months. SETTING: Two cardiac care units of the University Hospitals Leuven. PARTICIPANTS: One hundred and fifty-one intervention and 158 control patients aged 75 years or older admitted for acute cardiovascular disease or transcatheter aortic valve implantation. INTERVENTION: A nurse from the geriatrics department performed a comprehensive geriatric assessment within 24 h of admission. The cardiac care team and geriatrics nurse drafted an interdisciplinary care plan, focusing on early rehabilitation, discharge planning, promoting physical activity, and preventing geriatric syndromes. The geriatrics nurse provided daily follow-up and coached the cardiac team. A geriatrician co-managed patients with complications. MEASUREMENTS: The primary outcome was functional status measured using the Katz Index for independence in activities of daily living (ADL; one-point difference was considered clinically relevant). Secondary outcomes included the incidence of ADL decline and complications, length of stay, unplanned readmissions, survival, and quality of life. RESULTS: The mean age of patients was 85 years. Intervention patients had better functional status at hospital discharge (8.9, 95% CI = 8.7-9.3 versus 9.5, 95% CI = 9.2-9.9; p = 0.019) and experienced 18% less functional decline during hospitalization (25% vs. 43%, p = 0.006). The intervention group experienced significantly fewer cases of delirium and obstipation during hospitalization, and significantly fewer nosocomial infections. At 6-month follow-up, patients had significantly better functional status and quality of life. There were no differences regarding length of stay, readmissions, or survival. CONCLUSION: This first nurse-led geriatric co-management program for frail patients on cardiac care units was not effective in improving functional status, but significantly improved secondary outcomes.


Subject(s)
Cardiac Rehabilitation/nursing , Geriatric Nursing/methods , Patient Care Team , Patient Discharge/statistics & numerical data , Transcatheter Aortic Valve Replacement/rehabilitation , Acute Disease , Aged , Aged, 80 and over , Cardiology/methods , Cardiovascular Diseases/nursing , Female , Functional Status , Geriatric Assessment , Humans , Male , Non-Randomized Controlled Trials as Topic , Transcatheter Aortic Valve Replacement/nursing
5.
G Ital Cardiol (Rome) ; 21(4 Suppl 2): 60S-69S, 2020 04.
Article in Italian | MEDLINE | ID: mdl-32250372

ABSTRACT

Calcific degenerative aortic stenosis is the most frequent valve disease in the western population. Transcatheter aortic valve implantation procedures are significantly increasing, as they now represent the first choice in inoperable patients and have been shown to be non-inferior to cardiac surgery in patients at high and intermediate surgical risk. In this scenario, it is necessary to define and standardize the technical nursing care to guarantee patient safety and improve quality of care.The purpose of this document is to propose, on the basis on currently available literature, a model for the development of assistance based on shared objectives and clinical competence.


Subject(s)
Aortic Valve Stenosis/surgery , Aortic Valve/pathology , Calcinosis/surgery , Transcatheter Aortic Valve Replacement/methods , Aortic Valve/surgery , Clinical Competence , Humans , Italy , Patient Safety , Quality of Health Care , Transcatheter Aortic Valve Replacement/nursing , Transcatheter Aortic Valve Replacement/standards
7.
J Vasc Nurs ; 36(4): 186-188, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30458940

ABSTRACT

The purpose of this article is to inform nurses of the latest trend in the care of patients with aortic stenosis using transcatheter aortic valve replacement and pertinent knowledge regarding the care of these patients.


Subject(s)
Aortic Valve Stenosis/nursing , Heart Valve Prosthesis , Nursing Care/methods , Transcatheter Aortic Valve Replacement/adverse effects , Transcatheter Aortic Valve Replacement/nursing , Humans , Risk Factors , Severity of Illness Index , Treatment Outcome
8.
Dimens Crit Care Nurs ; 33(2): 49-56, 2014.
Article in English | MEDLINE | ID: mdl-24496250

ABSTRACT

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.


Subject(s)
Aortic Valve Stenosis/nursing , Aortic Valve Stenosis/surgery , Critical Care Nursing , Nurse's Role , Postoperative Complications/nursing , Transcatheter Aortic Valve Replacement/nursing , Aged , Disease Progression , Humans
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