Is transcatheter aortic valve replacement a safe treatment for elderly patients with severe aortic valve stenosis?

PURPOSE: This article's purpose is to make advanced practice nurses (APNs) aware of a minimally invasive transcatheter aortic valve replacement (TAVR) for treating symptomatic severe aortic valve stenosis in elderly patients. These patients are not safe surgical candidates because of their age and prohibitive risk profile, but they can benefit from valve replacement.

METHODS: A systematic literature review was completed by searching online databases such as CINAHL, PubMed, and Google. Research articles from 2008 to 2014 were retrieved from various medical journals such as The American Journal of Cardiology, Yale Journal of Biology and Medicine, Journal of the American Medical Association, and New England Journal of Medicine. Key words used in the search were aortic valve replacement, elderly patients, and severe aortic stenosis (AS).

CONCLUSION: Minimally invasive TAVR is highly superior to the medical treatment including aortic valvuloplasty and is noninferior to the surgical aortic valve replacement for the treatment of symptomatic severe aortic valve stenosis in elderly patients who are not safe surgical candidates.

IMPLICATIONS FOR PRACTICE: APNs have the education and skills to diagnose AS. Hence, they should stay abreast of new treatments and provide safe care and referrals for their patients diagnosed with severe AS.