Interpretation of <i>Chinese Expert Consensus on Perioperative Nursing of Transcatheter Aortic Valve Replacement</i>_West China Medical Journal

Authors：

GE Yan , CHEN Zhonglan , ZHAO Zhengang , PENG Yong , WEI Jiafu ,  ZHENG Mingxia

Department of Cardiology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHENG Mingxia, Email: zhengmingxia353@163.com

Keywords：

Transcatheter aortic valve replacement; perioperative nursing; expert consensus; interpretation

DOI：

10.7507/1002-0179.202408346

Video：

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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.

1.	经导管主动脉瓣置换术流程优化共识专家组. 经导管主动脉瓣置换术(TAVR)流程优化专家共识 2022 版. 中华急诊医学杂志, 2022, 31(2): 154-160.
2.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 经导管主动脉瓣置换术围术期护理中国专家共识. 中华心血管病杂志, 2024, 52(9): 1033-1043.
3.	中华医学会老年医学分会, 《中华老年医学杂志》编辑委员会. 老年人衰弱预防中国专家共识(2022). 中华老年医学杂志, 2022, 41(5): 503-511.
4.	Koh LY, Hwang NC. Frailty in cardiac surgery. J Cardiothorac Vasc Anesth, 2019, 33(2): 521-531.
5.	Hermiller JB Jr, Yakubov SJ, Reardon MJ, et al. Predicting early and late mortality after transcatheter aortic valve replacement. J Am Coll Cardiol, 2016, 68(4): 343-352.
6.	Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.
7.	中华医学会心血管病学分会老年学组, 国家老年疾病临床医学研究中心(解放军总医院). 老年心血管疾病合并衰弱评估与管理中国专家共识. 中华老年多器官疾病杂志, 2023, 22(7): 481-491.
8.	中华医学会老年医学分会, 解放军总医院老年医学教研室. 老年患者术前评估中国专家建议(2015). 中华老年医学杂志, 2015, 34(11): 1273-1280.
9.	Church S, Rogers E, Rockwood K, et al. A scoping review of the Clinical Frailty Scale. BMC Geriatr, 2020, 20(1): 393.
10.	Mack MJ, Leon MB, Smith CR, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
11.	Popma JJ, Deeb GM, Yakubov SJ, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med, 2019, 380(18): 1706-1715.
12.	Gomez CA, Braghiroli J, de Marchena E. “The changing paradigm”: TAVR for low-risk patients approved by the FDA. J Card Surg, 2020, 35(1): 5-7.
13.	中国医师协会心血管内科医师分会结构性心脏病专业委员会, 中华医学会心血管病学分会结构性心脏病学组. 经导管主动脉瓣置换团队建设及运行规范中国专家建议. 中国介入心脏病学杂志, 2018, 26(1): 2-6.
14.	Thomas M, Schymik G, Walther T, et al. Thirty-day results of the Sapien aortic bioprosthesis european outcome (SOURCE) registry: a European registry of transcatheter aortic valve implantation using the Edwards Sapien valve. Circulation, 2010, 122(1): 62-69.
15.	Eltchaninoff H, Prat A, Gilard M, et al. Transcatheter aortic valve implantation: early results of the FRANCE (French aortic national corevalve and Edwards) registry. Eur Heart J, 2011, 32(2): 191-197.
16.	Zahn R, Gerckens U, Grube E, et al. Transcatheter aortic valve implantation: first results from a multi-centre real-world registry. Eur Heart J, 2011, 32(2): 198-204.
17.	Tchetche D, Farah B, Misuraca L, et al. Cerebrovascular events post-transcatheter aortic valve replacement in a large cohort of patients: a FRANCE-2 registry substudy. JACC Cardiovasc Interv, 2014, 7(10): 1138-1145.
18.	Tay EL, Gurvitch R, Wijesinghe N, et al. A high-risk period for cerebrovascular events exists after transcatheter aortic valve implantation. JACC Cardiovasc Interv, 2011, 4(12): 1290-1297.
19.	Hynes BG, Rodés-Cabau J. Transcatheter aortic valve implantation and cerebrovascular events: the current state of the art. Ann N Y Acad Sci, 2012, 1254: 151-163.
20.	Antipova D, Eadie L, Macaden A, et al. Diagnostic accuracy of clinical tools for assessment of acute stroke: a systematic review. BMC Emerg Med, 2019, 19(1): 49.
21.	Kapadia SR, Huded CP, Kodali SK, et al. Stroke after surgical versus transfemoral transcatheter aortic valve replacement in the PARTNER trial. J Am Coll Cardiol, 2018, 72(20): 2415-2426.
22.	York NL, Kane C, Smith CS. Identification and management of acute cardiac tamponade. Dimens Crit Care Nurs, 2018, 37(3): 130-134.
23.	Sherwood MW, Xiang K, Matsouaka R, et al. Incidence, temporal trends, and associated outcomes of vascular and bleeding complications in patients undergoing transfemoral transcatheter aortic valve replacement: insights from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry. Circ Cardiovasc Interv, 2020, 13(1): e008227.
24.	Ruge H, Burri M, Erlebach M, et al. Access site related vascular complications with third generation transcatheter heart valve systems. Catheter Cardiovasc Interv, 2021, 97(2): 325-332.
25.	Zhang B, Kim M, Griffiths C, et al. Incidence of splanchnic vein thrombosis after abdominal surgery: a systematic review and meta-analysis. J Surg Res, 2020, 245: 500-509.
26.	中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第三版). 中国血管外科杂志(电子版), 2017, 9(4): 250-257.
27.	Tick LW, Kramer MH, Rosendaal FR, et al. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis. J Thromb Haemost, 2008, 6(12): 2075-2081.
28.	《中国血栓性疾病防治指南》专家委员会. 中国血栓性疾病防治指南. 中华医学杂志, 2018, 98(36): 2861-2888.
29.	中华护理学会外科护理专业委员会, 中华医学会外科学分会护理学组. 普通外科患者静脉血栓栓塞症风险评估与预防护理专家共识. 中华护理杂志, 2022, 57(4): 444-449.
30.	Chu CS, Liang CK, Chou MY, et al. Mini-Nutritional Assessment Short-Form as a useful method of predicting poor 1-year outcome in elderly patients undergoing orthopedic surgery. Geriatr Gerontol Int, 2017, 17(12): 2361-2368.
31.	Maruyama K, Nakagawa N, Koyama S, et al. Malnutrition increases the incidence of death, cardiovascular events, and infections in patients with stroke after rehabilitation. J Stroke Cerebrovasc Dis, 2018, 27(3): 716-723.
32.	Bhatia N, Basra SS, Skolnick AH, et al. Aortic valve disease in the older adult. J Geriatr Cardiol, 2016, 13(12): 941-944.
33.	Skipper A, Coltman A, Tomesko J, et al. Adult malnutrition (undernutrition) screening: an evidence analysis center systematic review. J Acad Nutr Diet, 2020, 120(4): 669-708.
34.	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
35.	Doi S, Ashikaga K, Kida K, et al. Prognostic value of Mini Nutritional Assessment-Short Form with aortic valve stenosis following transcatheter aortic valve implantation. ESC Heart Fail, 2020, 7(6): 4024-4031.

1. 经导管主动脉瓣置换术流程优化共识专家组. 经导管主动脉瓣置换术(TAVR)流程优化专家共识 2022 版. 中华急诊医学杂志, 2022, 31(2): 154-160.
2. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 经导管主动脉瓣置换术围术期护理中国专家共识. 中华心血管病杂志, 2024, 52(9): 1033-1043.
3. 中华医学会老年医学分会, 《中华老年医学杂志》编辑委员会. 老年人衰弱预防中国专家共识(2022). 中华老年医学杂志, 2022, 41(5): 503-511.
4. Koh LY, Hwang NC. Frailty in cardiac surgery. J Cardiothorac Vasc Anesth, 2019, 33(2): 521-531.
5. Hermiller JB Jr, Yakubov SJ, Reardon MJ, et al. Predicting early and late mortality after transcatheter aortic valve replacement. J Am Coll Cardiol, 2016, 68(4): 343-352.
6. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.
7. 中华医学会心血管病学分会老年学组, 国家老年疾病临床医学研究中心(解放军总医院). 老年心血管疾病合并衰弱评估与管理中国专家共识. 中华老年多器官疾病杂志, 2023, 22(7): 481-491.
8. 中华医学会老年医学分会, 解放军总医院老年医学教研室. 老年患者术前评估中国专家建议(2015). 中华老年医学杂志, 2015, 34(11): 1273-1280.
9. Church S, Rogers E, Rockwood K, et al. A scoping review of the Clinical Frailty Scale. BMC Geriatr, 2020, 20(1): 393.
10. Mack MJ, Leon MB, Smith CR, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
11. Popma JJ, Deeb GM, Yakubov SJ, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med, 2019, 380(18): 1706-1715.
12. Gomez CA, Braghiroli J, de Marchena E. “The changing paradigm”: TAVR for low-risk patients approved by the FDA. J Card Surg, 2020, 35(1): 5-7.
13. 中国医师协会心血管内科医师分会结构性心脏病专业委员会, 中华医学会心血管病学分会结构性心脏病学组. 经导管主动脉瓣置换团队建设及运行规范中国专家建议. 中国介入心脏病学杂志, 2018, 26(1): 2-6.
14. Thomas M, Schymik G, Walther T, et al. Thirty-day results of the Sapien aortic bioprosthesis european outcome (SOURCE) registry: a European registry of transcatheter aortic valve implantation using the Edwards Sapien valve. Circulation, 2010, 122(1): 62-69.
15. Eltchaninoff H, Prat A, Gilard M, et al. Transcatheter aortic valve implantation: early results of the FRANCE (French aortic national corevalve and Edwards) registry. Eur Heart J, 2011, 32(2): 191-197.
16. Zahn R, Gerckens U, Grube E, et al. Transcatheter aortic valve implantation: first results from a multi-centre real-world registry. Eur Heart J, 2011, 32(2): 198-204.
17. Tchetche D, Farah B, Misuraca L, et al. Cerebrovascular events post-transcatheter aortic valve replacement in a large cohort of patients: a FRANCE-2 registry substudy. JACC Cardiovasc Interv, 2014, 7(10): 1138-1145.
18. Tay EL, Gurvitch R, Wijesinghe N, et al. A high-risk period for cerebrovascular events exists after transcatheter aortic valve implantation. JACC Cardiovasc Interv, 2011, 4(12): 1290-1297.
19. Hynes BG, Rodés-Cabau J. Transcatheter aortic valve implantation and cerebrovascular events: the current state of the art. Ann N Y Acad Sci, 2012, 1254: 151-163.
20. Antipova D, Eadie L, Macaden A, et al. Diagnostic accuracy of clinical tools for assessment of acute stroke: a systematic review. BMC Emerg Med, 2019, 19(1): 49.
21. Kapadia SR, Huded CP, Kodali SK, et al. Stroke after surgical versus transfemoral transcatheter aortic valve replacement in the PARTNER trial. J Am Coll Cardiol, 2018, 72(20): 2415-2426.
22. York NL, Kane C, Smith CS. Identification and management of acute cardiac tamponade. Dimens Crit Care Nurs, 2018, 37(3): 130-134.
23. Sherwood MW, Xiang K, Matsouaka R, et al. Incidence, temporal trends, and associated outcomes of vascular and bleeding complications in patients undergoing transfemoral transcatheter aortic valve replacement: insights from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry. Circ Cardiovasc Interv, 2020, 13(1): e008227.
24. Ruge H, Burri M, Erlebach M, et al. Access site related vascular complications with third generation transcatheter heart valve systems. Catheter Cardiovasc Interv, 2021, 97(2): 325-332.
25. Zhang B, Kim M, Griffiths C, et al. Incidence of splanchnic vein thrombosis after abdominal surgery: a systematic review and meta-analysis. J Surg Res, 2020, 245: 500-509.
26. 中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第三版). 中国血管外科杂志(电子版), 2017, 9(4): 250-257.
27. Tick LW, Kramer MH, Rosendaal FR, et al. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis. J Thromb Haemost, 2008, 6(12): 2075-2081.
28. 《中国血栓性疾病防治指南》专家委员会. 中国血栓性疾病防治指南. 中华医学杂志, 2018, 98(36): 2861-2888.
29. 中华护理学会外科护理专业委员会, 中华医学会外科学分会护理学组. 普通外科患者静脉血栓栓塞症风险评估与预防护理专家共识. 中华护理杂志, 2022, 57(4): 444-449.
30. Chu CS, Liang CK, Chou MY, et al. Mini-Nutritional Assessment Short-Form as a useful method of predicting poor 1-year outcome in elderly patients undergoing orthopedic surgery. Geriatr Gerontol Int, 2017, 17(12): 2361-2368.
31. Maruyama K, Nakagawa N, Koyama S, et al. Malnutrition increases the incidence of death, cardiovascular events, and infections in patients with stroke after rehabilitation. J Stroke Cerebrovasc Dis, 2018, 27(3): 716-723.
32. Bhatia N, Basra SS, Skolnick AH, et al. Aortic valve disease in the older adult. J Geriatr Cardiol, 2016, 13(12): 941-944.
33. Skipper A, Coltman A, Tomesko J, et al. Adult malnutrition (undernutrition) screening: an evidence analysis center systematic review. J Acad Nutr Diet, 2020, 120(4): 669-708.
34. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
35. Doi S, Ashikaga K, Kida K, et al. Prognostic value of Mini Nutritional Assessment-Short Form with aortic valve stenosis following transcatheter aortic valve implantation. ESC Heart Fail, 2020, 7(6): 4024-4031.

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