Postoperative Care for Transcatheter Aortic Valve Replacement

Abstract

TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR), sometimes called transcatheter aortic valve implantation, is a relatively new therapy that was first approved for use in the United States in 2011. 1 Grover F.L. Vemulapalli S. Carroll J.D. et al. 2016 Annual Report of The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Ann Thorac Surg. 2017; 103: 1021-1035 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Since the therapy's introduction, TAVR has increasingly become an effective alternative to surgical aortic valve repair to treat symptomatic aortic stenosis (AS) in high surgical risk or inoperable patients. 2 Kundi H. Strom J.B. Valsdottir L.R. et al. Trends in isolated surgical aortic valve replacement according to hospital-based transcatheter aortic valve replacement volumes. JACC Cardiovasc Interv. 2018; 11: 2148-2156 Crossref PubMed Scopus (50) Google Scholar , 3 Leon M.B. Smith C.R. Mack M. et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010; 363: 1597-1607 Crossref PubMed Scopus (5427) Google Scholar , 4 Leon M.B. Smith C.R. Mack M.J. et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016; 374: 1609-1620 Crossref PubMed Scopus (3216) Google Scholar Demand for this procedure has continued to grow with an increase in the number of health care centers performing TAVR procedures nationwide and continuing research extending the procedure for populations with AS. 4 Leon M.B. Smith C.R. Mack M.J. et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016; 374: 1609-1620 Crossref PubMed Scopus (3216) Google Scholar , 5 Auffret V. Puri R. Urena M. et al. Conduction disturbances after transcatheter aortic valve replacement: Current status and future perspectives. Circulation. 2017; 136: 1049-1069 Crossref PubMed Scopus (289) Google Scholar Although TAVR is effective as a treatment option for AS, it is not without significant risks. Joshua V. Williams, BSN, RN, CCRN-K, Aeromedical Evacuation Civilian Institution Program, Air Force Institute of Technology, Wright-Patterson Air Force Base, OH Mary Beth Flynn Makic, PhD, RN, CCNS, CCRN-K, FAAN, FNAP, College of Nursing, University of Colorado, Aurora, CO