Investigation and analysis of operations, intraoperative instruments and nursing status of transcatheter aortic valve replacement in China_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHU Li ¹ , XU Bingchen ¹ , PAN Wenzhi ¹ , JIN Jianhao ¹ , HOU Guihua ² ,  GE Junbo ¹

1. Department of Cardiology, Cardiovascular Intervention Center, Zhongshan Hospital Fudan University, Shanghai, 200032, P. R. China;
2. Department of Cardiology, Peking University First Hospital, Beijing, 100034, P. R. China;

Corresponding?author：

GE Junbo, Email: ge.junbo@zs-hospital.sh.cn

Keywords：

Transcatheter aortic valve replacement; complications; instruments; nursing

DOI：

10.7507/1007-4848.202105039

Video：

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Objective To investigate the operation of transcatheter aortic valve replacement (TAVR), the use of TAVR instruments and the current situation of TAVR-related nursing in our country, to reveal the characteristics of TAVR in various hospitals in our country, and to provide reference data for improving perioperative nursing and industry development of TAVR. Methods A questionnaire survey was conducted among the head nurses of the cardiac catheterization laboratories of 51 hospitals in China that carried out TAVR operations, with a total of 5 items and 23 questions. The current situation of TAVR operation methods, intraoperative instruments and nursing care in China were analyzed. Results The number of hospitals in China which started conducting TAVR and the beginning year were: 2 in 2010, 1 in 2012, 1 in 2013, 1 in 2015, 11 in 2016, 13 in 2017, 15 in 2018 and 7 in 2019; the number of transfemoral TAVR in 2019: 32 (62.75%) hospitals conducted on less than 20 patients, 7 (13.73%) hospitals 20-<50 patients, 6 (11.76%) hospitals 50-100 patients and 6 (11.76%) hospitals more than 100 patients; TAVR strategies adopted by most hospitals were: general anesthesia (90.20%), the use of vascular sealers (80.39%), backing by cardiac surgeon (74.51%) and using homemade prosthetic valves. Conclusion At present, the number of TAVR carried out in Chinese hospitals is still far behind that of developed countries in Europe and the United States. Our country has adopted the form of multidisciplinary cardiac team cooperation and formed a TAVR nursing model with Chinese characteristics.

Citation： ZHU Li, XU Bingchen, PAN Wenzhi, JIN Jianhao, HOU Guihua, GE Junbo. Investigation and analysis of operations, intraoperative instruments and nursing status of transcatheter aortic valve replacement in China. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(2): 238-244. doi: 10.7507/1007-4848.202105039 Copy

1.	中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 經導管主動脈瓣置換術中國專家共識(2020更新版). 中國介入心臟病學雜志, 2020, 28(6): 301-309.
2.	Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation, 2021, 143(5): e35-e71.
3.	潘文志, 龍愉良, 周達新, 等. 2020年經導管瓣膜治療主要進展. 中國胸心血管外科臨床雜, 2021, 28(4): 371-375.
4.	徐先增. 經導管主動脈瓣植入術并發癥研究進展. 微創醫學, 2012, 7(4): 403-406.
5.	Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: A population-based study. Lancet, 2006, 368(9540): 1005-1011.
6.	Carroll JD, Mack MJ, Vemulapalli S, et al. STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol, 2020, 76(21): 2492-2516.
7.	Lester SJ, Heilbron B, Gin K, et al. The natural history and rate of progression of aortic stenosis. Chest, 1998, 113(4): 1109-1114.
8.	Stouffer GA, Lenihan DJ, Lerakis S, et al. Timing of aortic valve surgery in chronic aortic stenosis and regurgitation. Am J Med Sci, 2004, 327(6): 348-351.
9.	Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
10.	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.
11.	Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
12.	Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med, 2019, 380(18): 1695-1705.
13.	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.
14.	葛均波, 周達新, 潘文志, 等. 經皮主動脈瓣植入術一例及其附操作要點. 中國介入心臟病學雜志, 2010, 18(5): 243-246.
15.	Otto CM, Kumbhani DJ, Alexander KP, et al. 2017 ACC expert consensus decision pathway for transcatheter aortic valve replacement in the management of adults with aortic stenosis: A report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol, 2017, 69(10): 1313-1346.
16.	Auffret V, Puri R, Urena M, et al. Conduction disturbances after transcatheter aortic valve replacement: Current status and future perspectives. Circulation, 2017, 136(11): 1049-1069.
17.	Sawaya FJ, Lefèvre T, Spaziano M, et al. Transfemoral transcatheter aortic valve implantation: How minimalistic can we become? J Interv Cardiol, 2016, 29(6): 628-631.
18.	張昆, 孫路路, 張耀霞, 等. 經導管主動脈瓣置入術不同手術路徑8例的護理配合. 心血管外科雜志(電子版), 2015, 4(1): 43-45.
19.	Rodés-Cabau J, Ellenbogen KA, Krahn AD, et al. Management of conduction disturbances associated with transcatheter aortic valve replacement: JACC scientific expert panel. J Am Coll Cardiol, 2019, 74(8): 1086-1106.
20.	Siontis GC, Jüni P, Pilgrim T, et al. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR: A meta-analysis. J Am Coll Cardiol, 2014, 64(2): 129-140.
21.	Liao YB, Zhao ZG, Wei X, et al. Transcatheter aortic valve implantation with the self-expandable Venus A-Valve and CoreValve devices: Preliminary experiences in China. Catheter Cardiovasc Interv, 2017, 89(S1): 528-533.
22.	Zhou D, Pan W, Wang J, et al. VitaFlow^TM transcatheter valve system in the treatment of severe aortic stenosis: One-year results of a multicenter study. Catheter Cardiovasc Interv, 2020, 95(2): 332-338.

1. 中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 經導管主動脈瓣置換術中國專家共識(2020更新版). 中國介入心臟病學雜志, 2020, 28(6): 301-309.
2. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation, 2021, 143(5): e35-e71.
3. 潘文志, 龍愉良, 周達新, 等. 2020年經導管瓣膜治療主要進展. 中國胸心血管外科臨床雜, 2021, 28(4): 371-375.
4. 徐先增. 經導管主動脈瓣植入術并發癥研究進展. 微創醫學, 2012, 7(4): 403-406.
5. Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: A population-based study. Lancet, 2006, 368(9540): 1005-1011.
6. Carroll JD, Mack MJ, Vemulapalli S, et al. STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol, 2020, 76(21): 2492-2516.
7. Lester SJ, Heilbron B, Gin K, et al. The natural history and rate of progression of aortic stenosis. Chest, 1998, 113(4): 1109-1114.
8. Stouffer GA, Lenihan DJ, Lerakis S, et al. Timing of aortic valve surgery in chronic aortic stenosis and regurgitation. Am J Med Sci, 2004, 327(6): 348-351.
9. Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
10. 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.
11. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
12. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med, 2019, 380(18): 1695-1705.
13. 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.
14. 葛均波, 周達新, 潘文志, 等. 經皮主動脈瓣植入術一例及其附操作要點. 中國介入心臟病學雜志, 2010, 18(5): 243-246.
15. Otto CM, Kumbhani DJ, Alexander KP, et al. 2017 ACC expert consensus decision pathway for transcatheter aortic valve replacement in the management of adults with aortic stenosis: A report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol, 2017, 69(10): 1313-1346.
16. Auffret V, Puri R, Urena M, et al. Conduction disturbances after transcatheter aortic valve replacement: Current status and future perspectives. Circulation, 2017, 136(11): 1049-1069.
17. Sawaya FJ, Lefèvre T, Spaziano M, et al. Transfemoral transcatheter aortic valve implantation: How minimalistic can we become? J Interv Cardiol, 2016, 29(6): 628-631.
18. 張昆, 孫路路, 張耀霞, 等. 經導管主動脈瓣置入術不同手術路徑8例的護理配合. 心血管外科雜志(電子版), 2015, 4(1): 43-45.
19. Rodés-Cabau J, Ellenbogen KA, Krahn AD, et al. Management of conduction disturbances associated with transcatheter aortic valve replacement: JACC scientific expert panel. J Am Coll Cardiol, 2019, 74(8): 1086-1106.
20. Siontis GC, Jüni P, Pilgrim T, et al. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR: A meta-analysis. J Am Coll Cardiol, 2014, 64(2): 129-140.
21. Liao YB, Zhao ZG, Wei X, et al. Transcatheter aortic valve implantation with the self-expandable Venus A-Valve and CoreValve devices: Preliminary experiences in China. Catheter Cardiovasc Interv, 2017, 89(S1): 528-533.
22. Zhou D, Pan W, Wang J, et al. VitaFlow^TM transcatheter valve system in the treatment of severe aortic stenosis: One-year results of a multicenter study. Catheter Cardiovasc Interv, 2020, 95(2): 332-338.

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