title: Transcatheter aortic valve replacement options for severe aortic stenosis in high-risk patients.
abstract: BACKGROUND
  Calcific aortic stenosis has now become the most common valvular disease in Western countries. It is a disease of the old and very old. Senile calcific aortic stenosis affects 5% of the population 70 years or older in the United States. Traditionally, the gold standard for treating aortic stenosis has been surgical aortic valve replacement. Unfortunately, surgical aortic valve replacement is, in many cases, not a viable option for this patient population.
  
  
  OBJECTIVE
  This article examines transcatheter aortic valve replacement as an evolving technology and medical procedure with the high-risk and inoperable patients in mind. Since then, the geriatric patient population is ever increasing and the numbers of severe aortic stenosis cases are expected to increase accordingly. It is vital for healthcare professionals to be well informed to give competent care.
  
  
  CONCLUSIONS
  International research over the last decade has shown promising results in improved quality of life with regard to pain, functional status, and overall health. This research has expanded to the United States within the last few years. Two transcatheter aortic valve systems are available for use and are being researched. The Placement of AoRTic TraNscathetER Valve Trial (PARTNER trial) (Edwards SAPIEN valve) and the US Pivotal study (Medtronic CoreValve) are 2 large studies being conducted, and the medical community is anxiously awaiting results.
  
  
  CONCLUSIONS
  These complex patients require a team approach between the interventional cardiologist, primary cardiologist, cardiac surgeons, and highly trained nursing staff. The transcatheter aortic valve replacement nurse coordinator is a core member of the team, and the contributions of that individual are vital to program success. To avoid complications, careful patient selection is important, and a highly trained valve clinic coordinator must perform a careful and thorough assessment.
authors.affiliation: Anita Lachell, MSN, CRNP, RN Acute Care Nurse Practitioner, Heart and Vascular Institute, Division of Adult Cardiac Surgery, University of Pittsburgh Medical Center, Pennsylvania. Lisa Henry, DNP, CRNP, AACC Clinical Project Director, UPMC Heart and Vascular Institute, Pittsburgh, Pennsylvania.
authors.forename: Anita
authors.initials: A
authors.lastname: Lachell
authors.forename: Lisa
authors.initials: L
authors.lastname: Henry
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D002986:Clinical Trials as Topic; D006350:Heart Valve Prosthesis; D006801:Humans; D024802:Nurse's Role; D018579:Patient Selection; D012720:Severity of Illness Index; D065467:Transcatheter Aortic Valve Replacement