Peri-procedure experiences during minimalist transcatheter aortic valve implantation: insights from patients' perspectives
Bibliographic record
Abstract
Abstract Funding Acknowledgements Type of funding sources: None. Background There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve program capacity, and facilitate safe early discharge home after transcatheter aortic valve implantation (TAVI). In the peri-procedure phase, the adoption of a minimalist approach has accelerated the rapid transition from the use of general anaesthesia to default strategies ranging from conscious sedation to local anaesthesia only. Little is known of patients’ perspectives with undergoing minimalist TAVI. We aimed to explore what could be learned from this episode of care to inform multidisciplinary practice. Methods We conducted a prospective single centre qualitative study of TAVI patients within the first week of their discharge home, using purposeful sample to recruit a diverse population. We conducted individual interviews, using a semi-structured interview guide informed by pilot work and current evidence; open-ended questions were designed to explore patients’ perspectives of their peri-procedural experiences, inclusive of their recall of the procedure, interactions with team members, and the overall care received. Data were analyzed using interpretive description, a methodological approach appropriate to inform the knowledge needs of applied disciplines and conducive to generating new ideas and augment existing knowledge in the context of clinical practice. Results We recruited 15 participants, including 5 women, median age 82 (IQR 77,86); all patients had severe symptomatic aortic stenosis and multiple co-morbidities. TAVI was conducted using a transfemoral approach, with local anaesthesia only (n=4) or minimal sedation (n=11). Median length of stay was 1 day; one participant required a new permanent pacemaker; all participants were discharged home. The overarching theme of "I want to be a member of my Heart Team during my procedure" emerged; this aspiration, request and/or need was illustrated by three main themes: (1) "Who am I to them?", (2) "How can I be a good patient?", and (3) "How do I manage this complex wave of emotions?". Conclusions The rapid emergence of minimally invasive options for the treatment of valvular heart disease has established a new standard of care. Peri-procedure care initially informed by surgical practices have now shifted to most patients being conscious during TAVI and cared for by a smaller clinical team. The awareness of patients’ perspectives, and their inclusion in the Heart Team’s dynamics and processes offer important insights to optimise patients’ experiences of procedural care and clinical outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.005 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".