‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation

Background: Internationally, transcatheter aortic valve implantation (TAVI) is the most common approach for treating aortic stenosis. There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve capacity and facilitate safe early discharge...

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Main Authors: Celeste Percy, Fuchsia Howard, Bobby Lee, Janarthanan Sathananthan, David Wood, John Webb, Sandra Lauck
Format: Article
Language:English
Published: Australian College of Perioperative Nurses 2024-02-01
Series:Journal of Perioperative Nursing
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Online Access:https://journal.acorn.org.au/index.php/jpn/article/view/96
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author Celeste Percy
Fuchsia Howard
Bobby Lee
Janarthanan Sathananthan
David Wood
John Webb
Sandra Lauck
author_facet Celeste Percy
Fuchsia Howard
Bobby Lee
Janarthanan Sathananthan
David Wood
John Webb
Sandra Lauck
author_sort Celeste Percy
collection DOAJ
description Background: Internationally, transcatheter aortic valve implantation (TAVI) is the most common approach for treating aortic stenosis. There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve capacity and facilitate safe early discharge home. Best practices that are emerging include adopting a minimalist approach and transition from general anaesthesia to conscious sedation or local anesthesia only. We aimed to explore what could be learned from patients’ experiences of their care in this rapidly evolving context. Methods: We conducted a qualitative study of patients in the first week after TAVI to explore their perspectives of the procedure and elicit their recommendations. We used interpretive description as the methodological approach to not only inform data collection and analysis but also to generate evidence to inform practice. Results: We recruited 15 participants, five women and ten men, with a mean age of 83 years (±5.4) who had transfemoral TAVI with minimal sedation (n=14) in a hybrid operating room (n=6) or a cardiac catheter laboratory (n=9) and were discharged home without complications the day after their procedure. The overarching theme of ‘I want to be a member of my heart team during my procedure’ emerged, and was illustrated by three themes: ‘Who am I to them?’ (situating self in relation to the team), ‘How can I be a good patient?’ (knowing expectations of me) and ‘How do I manage this complex wave of emotions?’ (interpreting team signals). Participants provided unique recommendations, including patient participation during safety checkpoints, communication protocols, education and raised awareness of patients’ needs during minimalist TAVI. Conclusions: The rapid emergence of minimalist approaches for the treatment of valvular heart disease warrants tailored strategies to integrate patients’ needs. Further research is needed to ensure the adoption of patient-centred practices during TAVI.
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spelling doaj-art-37f80d6428fc4a9898164d35f396c89f2025-08-20T03:53:42ZengAustralian College of Perioperative NursesJournal of Perioperative Nursing2209-10842209-10922024-02-0137110.26550/2209-1092.1285‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantationCeleste Percy0Fuchsia Howard1Bobby Lee2Janarthanan Sathananthan3David Wood4John Webb5Sandra Lauck6University of British ColumbiaUniversity of British ColumbiaUniversity of British ColumbiaUniversity of British ColumbiaUniversity of British ColumbiaUniversity of British ColumbiaUniversity of British Columbia Background: Internationally, transcatheter aortic valve implantation (TAVI) is the most common approach for treating aortic stenosis. There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve capacity and facilitate safe early discharge home. Best practices that are emerging include adopting a minimalist approach and transition from general anaesthesia to conscious sedation or local anesthesia only. We aimed to explore what could be learned from patients’ experiences of their care in this rapidly evolving context. Methods: We conducted a qualitative study of patients in the first week after TAVI to explore their perspectives of the procedure and elicit their recommendations. We used interpretive description as the methodological approach to not only inform data collection and analysis but also to generate evidence to inform practice. Results: We recruited 15 participants, five women and ten men, with a mean age of 83 years (±5.4) who had transfemoral TAVI with minimal sedation (n=14) in a hybrid operating room (n=6) or a cardiac catheter laboratory (n=9) and were discharged home without complications the day after their procedure. The overarching theme of ‘I want to be a member of my heart team during my procedure’ emerged, and was illustrated by three themes: ‘Who am I to them?’ (situating self in relation to the team), ‘How can I be a good patient?’ (knowing expectations of me) and ‘How do I manage this complex wave of emotions?’ (interpreting team signals). Participants provided unique recommendations, including patient participation during safety checkpoints, communication protocols, education and raised awareness of patients’ needs during minimalist TAVI. Conclusions: The rapid emergence of minimalist approaches for the treatment of valvular heart disease warrants tailored strategies to integrate patients’ needs. Further research is needed to ensure the adoption of patient-centred practices during TAVI. https://journal.acorn.org.au/index.php/jpn/article/view/96transcatheter aortic valve replacementperi-procedure nursingminimalist approachanaesthesiapatient experiencequalitative
spellingShingle Celeste Percy
Fuchsia Howard
Bobby Lee
Janarthanan Sathananthan
David Wood
John Webb
Sandra Lauck
‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
Journal of Perioperative Nursing
transcatheter aortic valve replacement
peri-procedure nursing
minimalist approach
anaesthesia
patient experience
qualitative
title ‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
title_full ‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
title_fullStr ‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
title_full_unstemmed ‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
title_short ‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
title_sort i want to be a member of my heart team insights from patients experiences of minimalist transcatheter aortic valve implantation
topic transcatheter aortic valve replacement
peri-procedure nursing
minimalist approach
anaesthesia
patient experience
qualitative
url https://journal.acorn.org.au/index.php/jpn/article/view/96
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