Intraoperative Nursing Care of Patients Undergoing Transcatheter Aortic Valve Replacement via Femoral Artery Approach

Xuanjing Li,Wenying Li,Shengqi Wang,Jian Yu,Xianzhen Huang,Fan Yang

doi:10.11648/j.ajns.20211001.19

Abstract

Objective: Intend to explore the main points of intraoperative nursing care of patients with aortic valve stenosis undergoing transcatheter aortic valve replacement through femoral artery approach, summarize the scientific and effective nursing methods in operation. Methods: The intraoperative nursing methods of 9 patients undergoing transcatheter aortic valve replacement through femoral artery approach in our hospital from November 2019 to January 2021 were analyzed retrospectively. These methods include preoperative preparation, transmission of operative consumables, invasive blood pressure monitoring, use of high pressure syringe and temporary pacemaker, nursing of balloon dilatation and valve release, observation and nursing of intraoperative complications, postoperative nursing and so on. Results: The success rate of transcatheter aortic valve replacement was 100% in 9 patients who underwent transcatheter aortic valve replacement through femoral artery approach. In addition, the average operation time was 194.1 minutes. Besides, 1 case was implanted with middle valve, 1 case was protected by coronary artery, and 1 case was rescued during postoperative transportation. Moreover, no serious operative complications such as valve stent shedding, perivalvular leakage, coronary artery occlusion, stroke and malignant arrhythmia occurred in 9 patients. Conclusion: Full preoperative preparation, familiarity with the whole operation process and key steps, proficiency in the use of high pressure syringe and temporary pacemaker and nursing cooperation during balloon dilatation and valve release are the key to the successful completion of the operation in transfemoral approach transcatheter aortic valve replacement. Through active and effective intraoperative nursing, the operative quality of transfemoral artery approach transcatheter aortic valve replacement can be improved effectively, the operative time can be shortened, and the occurrence of intraoperative complications can be reduced, and the life safety of patients can be guaranteed.

Highlights

The incidence of aortic valve stenosis is getting higher and higher with the aging of the population
The left femoral artery was bandaged with elastic bandage, and the patient was transferred to coronary care unit (CCU) or intensive care unit (ICU) for further observation and treatment
One patient was due to poor valve release position, but we got a satisfactory result after putting a Value-in-Value

Summary

Introduction

The incidence of aortic valve stenosis is getting higher and higher with the aging of the population. It is reported that the incidence of aortic valve stenosis is 4% at the age of 75 and 85 years old and 6% at the age of 85 [1]. As a consequence, it is a major cardiovascular disease affecting the health of the elderly population [2]. Transcatheter aortic valve replacement (TAVR) has the advantages of minimally invasive, good medium-and long-term effect. It can be used as an effective treatment for patients with high risk or surgical contraindication of aortic valve stenosis [3, 4]. TAVR via femoral artery approach is the most preferred surgical approach because of its minimally invasive and beneficial to Xuanjing Li et al.: Intraoperative Nursing care of Patients Undergoing Transcatheter Aortic Valve

Methods

Results

Discussion

Conclusion