‘I want to be a member of my heart team’: Insights from patients’ experiences of minimalist transcatheter aortic valve implantation
Bibliographic record
Abstract
Background: Internationally, transcatheter aortic valve implantation (TAVI) is the most common approach for treating aortic stenosis. There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve capacity and facilitate safe early discharge home. Best practices that are emerging include adopting a minimalist approach and transition from general anaesthesia to conscious sedation or local anesthesia only. We aimed to explore what could be learned from patients’ experiencesof their care in this rapidly evolving context. Methods: We conducted a qualitative study of patients in the first week after TAVI to explore their perspectives of the procedure and elicit their recommendations. We used interpretive description as the methodological approach to not only inform data collection and analysis but also to generate evidence to inform practice. Results: We recruited 15 participants, five women and ten men, with a mean age of 83 years (±5.4) who had transfemoral TAVI with minimal sedation (n=14) in a hybrid operating room (n=6) or a cardiac catheter laboratory (n=9) and were discharged home without complications the day after their procedure. The overarching theme of ‘I want to be a member of my heart team during my procedure’ emerged, and was illustrated by three themes: ‘Who am I tothem?’ (situating self in relation to the team), ‘How can I be a good patient?’ (knowing expectations of me) and ‘How do I manage this complex wave of emotions?’ (interpreting team signals). Participants provided unique recommendations, including patient participation during safety checkpoints, communication protocols, education and raised awareness of patients’ needs during minimalist TAVI. Conclusions: The rapid emergence of minimalist approaches for the treatment of valvular heart disease warrants tailored strategies to integrate patients’ needs. Further research is needed to ensure the adoption of patient-centred practices during TAVI.
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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) | 0.000 | 0.001 |
| 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".