Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for aortic stenosis. Clinical practice reduces the length of hospital stay of patients and promotes their early safe discharge home by adopting minimalist approach TAVR and standardized postoperative care. Foreign studies have shown that early discharge from hospital is safe and feasible, which can reduce medical costs and complications, but there are few relevant research in China. This article mainly reviews the assessment, influencing factors, and management strategies to promote early discharge of patients after TAVR, with the aim of providing references for the early discharge management practice of medical staff.
Transcatheter aortic valve replacement (TAVR) can effectively treat symptomatic severe aortic valve stenosis, and its applicable population is gradually expanding. The perioperative and rehabilitation care of TAVR is an important influencing factor for the success of the surgery. The release of the Chinese Expert Consensus on Perioperative Nursing of Transcatheter Aortic Valve Replacement has promoted the homogenization and high-quality care of TAVR patients in China. In order to better understand the key issues of TAVR perioperative nursing and serve clinical practice, this article provides a detailed interpretation of the above consensus based on five key issues of preoperative nursing, intraoperative monitoring, postoperative intensive care nursing, ward nursing, and nutritional assessment.
Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries. In 2020 ACC/AHA guideline, Valve in Valve (ViV) was recommended for high-risk patient instead of surgical mitral valve replacement. This report described a 77-year-old male patient with a failed mitral bioprosthetic valve, evaluated at high risk of surgery, received a transvenous, transseptal transcatheter mitral valve replacement (TMVR). Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea. The patient was transferred out of the CCU and discharged on the 3rd day. Compared with transapical access, transvenous transseptal access was less invasive, with shorter duration in CCU and hospitalization.