For many years, surgical aortic valve replacement (SAVR) was the gold-standard treatment for severe, symptomatic aortic stenosis (AS). For eligible patients, this procedure can improve symptoms and extend life. But it has a major drawback: Whether the surgical approach is open (using a full sternotomy) or less invasive (using a ministernotomy or minithoracotomy), SAVR requires cross-clamping of the aorta and cardiopulmonary bypass.
Transcatheter aortic valve replacement (TAVR), which involves a collapsible prosthetic valve placed directly over the native diseased valve, has emerged as a minimally invasive alternative to SAVR. A guide wire is fed through the aorta; then a catheter with a prosthetic valve on the end is fed over the wire and placed over the aortic valve. The prosthetic valve can be deployed percutaneously or through a small incision in the chest wall. The procedure takes 4 to 5 hours and is done in a hybrid cardiac catheterization laboratory.
This article reviews patient eligibility for TAVR, procedural approaches, prosthetic valve types, potential complications, nursing care, and patient education.
Key Learning Outcomes
Kelly Haight, MSN, APRN, ACNS-BC, PCCNKelly Haight is a clinical nurse specialist at the Cleveland Clinic in Cleveland, Ohio.
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