P93 THE POWER OF GROUP WORK IS THE STRENGTH OF A SUCCESS: TAVI!

Abstract

Abstract TAVI (Transcatheter Aortic Valve Implantation) is a procedure performed by a multidisciplinary team, preferably in a hybrid room where both interventional and cardiac surgery procedures are performed. This procedure is a splendid example of team work, where all the figures involved (hemodynamist, cardiac surgeon, anesthetist, sonographer and nurses) collaborate, each with a specific role, in the safe execution of the implantation of the transcatheter aortic valve in patients with high operative risk. Specifically, during the TAVI there are 4 nurses with very specific roles: CIRCULATING NURSE: • He/she welcomes the patient in pre–operating room (identification, checklist) • He/she transfers the patient to the hybrid room (positioning, etc.) • He/she supports the scrub nurse (materials, Pacemaker management) • He/she performs TIME–OUT and SIGN–OUTANESTHESIA NURSE: • He/she takes care of positioning all the monitoring instruments (ECG plates, defibrillator, etc. ..), finds all the venous accesses and supports the anesthetist (ventilation, intubation if necessary, EGA, ACT, etc …)SCRUB NURSE: • He/she collaborates with the hemodynamist in the execution of the procedure and in the management of sterile materials.CRIMPER NURSE: • He/she is responsible for the correct preparation of the valve and the material required for its assembly. This “new” competence of the nurse sees him engaged in the following activities: 1. preparation of the overbed table 2. preparation of catheters, introducers and any catheters for pre–dilatation (valvuloplasty) 3. preparation of valve delivery and positioning systems 4. valve washing 5. assembly and “crimping” of the valve At the end of the procedure, the nurses carry out the compressive dressing of the arterial and venous accesses, monitor and verify the correct arterial haemostasis by promptly intervening on any vascular complications (haemorrhages, pseudoaneurysms). Since October 2017, our Center has carried out numerous procedures with intra–operative and post–operative results comparable to national data, thanks to the efforts and commitment of our Heart Team. TAVI turns out to be an excellent example of teamwork, where success is given by the synergy between the various professional figures that are essential to each other.