TAVR

[NettersRN]

Hi! My hospital is developing a TAVR program. I currently work as an RN in a cath lab. I was wondering if any of you guys have had experience with this program... My manager asked me and another nurse to develop a help book for our department. Any advice about TAVR, experiences with working along side OR nurses, etc. would be greatly appreciated!! Thanks! :)

[michlynn, BSN, RN]

Our hospital has been doing this procedure for a while now, about 2 years now and I've seen mostly positive outcomes. We've only had one person pass secondary to TAVR complications and the doctor had warned this patient and family that he was high risk because of poor kidney function. What you have to remember about TAVR is that the patients are already high risk to begin with, they aren't surgical candidates and are typically over the age of 70 and this is their very last resort. Our doctors are making great strides with this procedure and our patients don't even leave with a scar anymore. They've completely gotten rid of the cutdown in the groin and now only do it through a small puncture like a heart cath. Our patients typically go to the ICU for one day, cardiac/tele unit for 2 days and are, for the most part, walking out of the hospital on the 3rd day with very very minimal risk for infection (no cutdown site) and very few physical restrictions.

[michlynn, BSN, RN]

Our temp pacer wires are also transvenous and secured in the groin through a sheath secured with sutures. The site is typically covered with a 4x4 and tegaderm dressing, we've never really had any problems with this. :)

[inthelab]

Agreed, these patients are extremely high risk and not candidates for open intervention. This procedure buys patients time but more so quality of life that they did not have. My facility is approx. 2 years into a TAVR program. The collaboration among the disciplines has been amazing. The OR nursing staff has been amazing, as well as the surgeons. The cath lab staff that has been privileged to participate love this collaboration and both sides have excelled. New technology and product are being advanced and this is quickly becoming a growing/evolving procedure for this very sick population.

[icurn1988]

My facility started tavr about a year or two ago. I would be very cautious about any patient getting them done. It is for high risk pt only so they are susceptible to complications. They tend to stay intubated or on pressors longer. A lot of the ones I have seen ended up needing a permanent pacemaker too.