Intraoperative Nursing Care of Patients Undergoing Transcatheter Aortic Valve Replacement via Femoral Artery Approach

Xuanjing Li, Shengqi Wang, Fan Yang, Jian Yu, Xianzhen Huang, Wenying Li
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Abstract

Objective: Intend to explore the main points of intraoperative nursing care of patients with aortic valve stenosis undergoing transcatheter aortic valve replacement through femoral artery approach, summarize the scientific and effective nursing methods in operation. Methods: The intraoperative nursing methods of 9 patients undergoing transcatheter aortic valve replacement through femoral artery approach in our hospital from November 2019 to January 2021 were analyzed retrospectively. These methods include preoperative preparation, transmission of operative consumables, invasive blood pressure monitoring, use of high pressure syringe and temporary pacemaker, nursing of balloon dilatation and valve release, observation and nursing of intraoperative complications, postoperative nursing and so on. Results: The success rate of transcatheter aortic valve replacement was 100% in 9 patients who underwent transcatheter aortic valve replacement through femoral artery approach. In addition, the average operation time was 194.1 minutes. Besides, 1 case was implanted with middle valve, 1 case was protected by coronary artery, and 1 case was rescued during postoperative transportation. Moreover, no serious operative complications such as valve stent shedding, perivalvular leakage, coronary artery occlusion, stroke and malignant arrhythmia occurred in 9 patients. Conclusion: Full preoperative preparation, familiarity with the whole operation process and key steps, proficiency in the use of high pressure syringe and temporary pacemaker and nursing cooperation during balloon dilatation and valve release are the key to the successful completion of the operation in transfemoral approach transcatheter aortic valve replacement. Through active and effective intraoperative nursing, the operative quality of transfemoral artery approach transcatheter aortic valve replacement can be improved effectively, the operative time can be shortened, and the occurrence of intraoperative complications can be reduced, and the life safety of patients can be guaranteed.
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经股动脉入路主动脉瓣置换术患者的术中护理
目的:探讨经股动脉入路经导管主动脉瓣置换术中主动脉瓣狭窄患者的术中护理要点,总结术中科学有效的护理方法。方法:回顾性分析2019年11月至2021年1月我院经股动脉入路行经导管主动脉瓣置换术的9例患者的术中护理方法。这些方法包括术前准备、手术耗材输送、有创血压监测、高压注射器及临时起搏器的使用、球囊扩张及瓣膜释放的护理、术中并发症的观察与护理、术后护理等。结果:经股动脉入路行经导管主动脉瓣置换术9例,成功率100%。平均手术时间为194.1分钟。植入中瓣1例,冠状动脉保护1例,术后转运抢救1例。9例患者无瓣膜支架脱落、瓣周渗漏、冠状动脉闭塞、脑卒中、恶性心律失常等严重手术并发症。结论:充分的术前准备,熟悉整个操作流程和关键步骤,熟练使用高压注射器和临时起搏器,以及球囊扩张和瓣膜释放过程中的护理配合,是经股入路经导管主动脉瓣置换术顺利完成手术的关键。通过积极有效的术中护理,可以有效提高经股动脉入路经导管主动脉瓣置换术的手术质量,缩短手术时间,减少术中并发症的发生,保证患者的生命安全。
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