An alternative approach in transcatheter aortic valve implantation – the role of the nurse

    Authors

    Keywords

    aortic stenosis, transcatheter aortic valve implantation, vascular access, alternative approach

    DOI

    https://doi.org/10.15836/ccar2025.292

    Full Text

    Aortic stenosis (AS) is the most common acquired valvular disease. Its prevalence is increasing as a result of population aging. When aortic stenosis becomes severe and symptomatic, valve replacement is indicated. Surgical aortic valve replacement is still considered the gold standard, but over the past two decades, minimally invasive transcatheter aortic valve implantation (TAVI) has proven to be an effective alternative to surgery. In most cases, the TAVI procedure can be performed using a retrograde transfemoral approach under local anesthesia. However, if the peripheral arteries are not of sufficient diameter for valve implantation, alternative access routes may be used, such as transaxillary, transcaval, transcarotid, transapical or direct aortic access (1). Aim is to present the key aspects of the TAVI procedure, including patient preparation, types of prosthetic valves, and potential perioperative complications. Nurses play an essential role as a member of TAVI team, either as scrub nurses or as those responsible for analgosedation and valve preparation. They also have a significant role in patient evaluation, preparation, and monitoring for complications. In alternative access approaches, the nurse’s role varies considerably depending on the type of access, primarily from an organizational standpoint, which makes these procedures more complex. Therefore, nurses must have a thorough understanding of alternative access routes so procedure preparation can be performed in the right way, as well as noticing and reacting to specific complications.

    Literature

    1. Lindman BR, Clavel MA, Mathieu P, Iung B, Lancellotti P, Otto CM, et al. Calcific aortic stenosis. Nat Rev Dis Primers. 2016 March 3;2:16006. https://doi.org/10.1038/nrdp.2016.6
    Cardiologia Croatica
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    An alternative approach in transcatheter aortic valve implantation – the role of the nurse

    Extended Abstract
    Issue11-12
    Published
    Pages292
    PDF via DOIhttps://doi.org/10.15836/ccar2025.292
    aortic stenosis
    transcatheter aortic valve implantation
    vascular access
    alternative approach

    Authors

    Antonija Baković*ORCIDUniversity Hospital Split, Split, Croatia
    Anita Martinović VranješUniversity Hospital Split, Split, Croatia

    *Correspondence email: antonijalaptop@gmail.com

    Full Text

    Aortic stenosis (AS) is the most common acquired valvular disease. Its prevalence is increasing as a result of population aging. When aortic stenosis becomes severe and symptomatic, valve replacement is indicated. Surgical aortic valve replacement is still considered the gold standard, but over the past two decades, minimally invasive transcatheter aortic valve implantation (TAVI) has proven to be an effective alternative to surgery. In most cases, the TAVI procedure can be performed using a retrograde transfemoral approach under local anesthesia. However, if the peripheral arteries are not of sufficient diameter for valve implantation, alternative access routes may be used, such as transaxillary, transcaval, transcarotid, transapical or direct aortic access (1). Aim is to present the key aspects of the TAVI procedure, including patient preparation, types of prosthetic valves, and potential perioperative complications.

    Nurses play an essential role as a member of TAVI team, either as scrub nurses or as those responsible for analgosedation and valve preparation. They also have a significant role in patient evaluation, preparation, and monitoring for complications. In alternative access approaches, the nurse’s role varies considerably depending on the type of access, primarily from an organizational standpoint, which makes these procedures more complex. Therefore, nurses must have a thorough understanding of alternative access routes so procedure preparation can be performed in the right way, as well as noticing and reacting to specific complications.

    Literature

    1. 1.
      Lindman BR, Clavel MA, Mathieu P, Iung B, Lancellotti P, Otto CM, et al. Calcific aortic stenosis. Nat Rev Dis Primers. 2016 March 3;2:16006.DOI