Transcatheter aortic valve implantation

Older adults with progressively worsening aortic valve stenosis are limited in their treatment options. Conventional treatment replaces the aortic valve via open-heart surgery, introducing numerous risks and increased mortality in older populations with comorbidities. In recent years, however, transcatheter aortic valve implantation (tAVI) has become a viable option for symptomatic, nonsurgical candidates. Although tAVI is available only to a select population, early randomized and nonrandomized clinical trials are offering insight into the new therapy, with promising results as this treatment continues to evolve.

This article examined the progression of tAVI therapies, from first-generation to third-generation devices and through 4 studies that address the utility of tAVI in symptomatic, nonsurgical candidates, in an effort to prepare nurses in the management of this newly emerging patient population.

A literature search was conducted of studies within the past 5 years that address transfemoral tAVI in adult populations. Transapical approaches were excluded.

Early outcomes demonstrate that successful implantation can improve valvular function and patient functional status. Nurses play a critical role in patient education and monitoring both before and after tAVI.

With increasing life expectancies and a prediction that many aging adults with aortic valve stenosis will be limited to tAVI, nurses need to gain familiarity with this novel therapy and its role in patient outcomes.