A Retrospective Study of Perioperative Nursing Care of Patients After Percutaneous Left Atrial Appendage Occlusion.

ABSTRACT

PURPOSE: To describe the retrospective audit examining nursing care of nonvalvular atrial fibrillation treated by percutaneous left atrial appendage closure (PLAAC). DESIGN: PLAAC is a new technique for patients with atrial fibrillation unsuited for long-term oral anticoagulation treatment. The nursing care for patients treated by PLAAC has not yet been standardized. METHODS: We performed a retrospective analysis of 259 patients with nonvalvular atrial fibrillation who underwent PLAAC in our department between August 2014 and June 2018. The data included preoperative evaluations, discussions, and preparations, including psychological care and atrial thrombosis screening; postoperative observations, including electrocardiograph monitoring; prevention and care of complications; administration of postoperative anticoagulation therapy; and postoperative education, including detailed discharge guidance and regular follow-up. FINDINGS: All patients were discharged after 5-10 days of hospitalization. In the perioperative period, 4 cases (1.5%) developed serious complications, including 3 cases (1.2%) of delayed cardiac tamponade, cured by pericardial drainage, and 1 case of a suspected air embolism, which spontaneously recovered. During a mean follow-up period of 25.9 ± 7.9 months, all patients had good adherence to medical instructions and there were no cases of occluder displacement or shedding, thromboembolism, or severe bleeding complications. CONCLUSIONS: The best therapeutic effect of PLAAC is strongly associated with the preoperative and postoperative training of nursing staff and the development of standard nursing procedures, including the establishment of observation and nursing manuals for complications. This study provides nursing practice information to aid in the standardization of nursing procedures for this new type of interventional therapy.