Authors

• Milka Grubišić — University Hospital Dubrava, Zagreb, Croatia

Keywords

transcathter aortic valve implantation surgery, nursing care

DOI

Full Text

**Introduction:** Transcatheter aortic valve implantation (TAVI) is a method for replacing stenotic aortic valve with bioprosthesis through transfemoral, transaortic or transapical approach. TAVI is indicated in patients with symptomatic severe aortic stenosis who are not candidates for surgical aortic valve replacement due to high operative risk and comorbidities. (1, 2) With aging of population there are more patients with severe aortic stenosis who can benefit from this innovative method that has been introduced in clinical practice since 2002. The success of TAVI procedure is combined effort and organization of each Heart Team. It is important, that the nurse who is an indispensable member of the Heart Team is well acquainted with the procedure, approaches for implantation (transfemoral, transapical or transaortic), multiple comorbidities of patients as well as most common postoperative complications (total atrioventricular block, atrial fibrillation, bleeding or groin wound infection). Although these patients are not entirely different from most cardiac surgical patients, their age, comorbidities and procedure itself makes their care special. Comorbidities that make care for such patients more complex such as diabetes, chronic renal failure, chronic heart failure, chronic obstructive pulmonary disease are often present. **Results:** First TAVI procedure in University Hospital Dubrava was performed in 2011. Since then with this method we have successfully treated 67 patients (58% males) with mean age of 80 years. 30-day survival was 98%, and three-year survival is 83% **Conclusion:** As the success of TAVI is dependent on preoperative care of patient in sense of better clinical and nutritive status, the important role is on medical care with goal of lowering postoperative complications, less time in ICU and better quality of life of elderly patients. Continuous nurses’ education and exchange of experience in perioperative care of these patients yields better TAVI results, and proves the important role of nurse in modern TAVI Heart Team.

Literature

1. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–607. https://doi.org/10.1056/NEJMoa1008232
2. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002;106(24):3006–8. https://doi.org/10.1161/01.CIR.0000047200.36165.B8