If you want to know more about anaesthetics in general, find out more from the Royal college of Anaesthetists. If needed, shaving will be done in hospital just before your TAVI. If the patient lives a significant distance away, their local cardiologist will often see them, following discussion with the transcatheter valve team. If you have any questions, please talk to your doctor. TAVI has been approved by the National Institute for Health and Care Excellence (NICE), which you can find out more about. You will receive an appointment to attend a pre-admission clinic approximately two weeks before your hospital admission date. Do not shave or remove hair from your chest, arms, legs or groin before your TAVI. If you have any concerns about any aspect of the service you have received in hospital and feel unable to talk to those people responsible for your care, call Patient Advice and Liaison Service (PALS): Alternatively, you can email pals@rbht.nhs.uk.
A respiratory function test measures how well your lungs are working.
If you have any questions, you can contact your TAVI nurse. Before confirming your TAVI procedure you may have one or more of the following tests: Blood tests check your general health. Talk to your GP or practice nurse about helping you to lose weight.
The CNS developed a flowchart for aortic valve assessment: "Transcatheter aortic valve implantation (TAVI) protocol investigations" as a reference for staff, as well as integrated care pathways (ICPs).
When you're ready for your TAVI, a member of staff will take you to the cardiac catheterisation laboratory (cath lab), on a bed or chair.
If we need to delay your TAVI for any reason, we will explain what happens next.
Patients may attend the Monday morning clinic, often with their relatives, to find out more about the assessment process and the procedure itself, and to undergo investigations such as blood tests, chest X-ray, ECHO and six-minute walk test. Germs (bacteria) can enter the bloodstream via your teeth and gums and get into the heart, which can cause a condition called endocarditis.
2).
Before deciding whether to have a TAVI, you can speak to a doctor or nurse about alternative treatments which may be available to you. The clinical team work in close relationship with leading members of industry, to ensure that the TAVI programme at Royal Brompton Hospital remains a driving force in the clinical and research development of this exciting new treatment for severe aortic …
TAVI clinical nurse specialist: 01895 823 737 ext. The aortic valve is one of four valves which controls the flow of blood out of the heart.
Small tubes, called catheters, are then inserted into the artery and vein at the site of the incision.
Ask your GP for a check-up if you have ongoing medical problems such as diabetes, asthma, bronchitis, thyroid problems or high blood pressure. There is a risk (2.5%) of damaging kidney function, and higher if you already have poor kidney function.
A CT scan takes about an hour.
Find out more about how to look after yourself before and after the TAVI procedure. The electrodes are connected to a monitor that records the rhythm and electrical activity of your heart. The specialist team includes heart surgeons, cardiologists, radiologists (imaging specialists), anaesthetists and specialist nurses. Continue to take your medicines as usual, unless your TAVI nurse or cardiologist has asked you not to. A coronary angiogram takes about 30 minutes. We'll also give you an ID card with the name and type of your valve. Endocarditis can damage the heart valves and cause other serious complications. A radiographer will give you an injection containing a special dye so that your blood vessels and heart show clearly on the scan.
We recommend that family and friends contact the individual ward directly to confirm visiting times before they come to the hospital. 85023, Parkwood House visitor accommodation: 01895 828 823, TAVI department: 020 7351 8121 ext.
By using an ultrasound scan's sound waves, a TOE transmits moving pictures of your heart. 3) is stitched to a stent (a small metal mesh tube), to hold it in place.
Loose teeth or crowns can also be problematic. If you have a TOE, your doctor will put a small tube into your food pipe (oesophagus) while you are under general anaesthetic.
The CNS works with the practice educators and provides teaching sessions as requested. Fewer than 5% of people will have moderate to severe leaking of the aortic valve (aortic regurgitation), which allows the blood to flow in the wrong direction.
Pre-medication (also called pre-meds) are drugs sometimes given before your anaesthetic. If this happens, the doctor will try to open the blocked artery by stretching it with a balloon and inserting a small metal tube (called a stent) in place to keep the artery open. You will need the ID card if you have an MRI scan in the future. The primary role of the clinical nurse specialist (CNS) is to support patients, relatives and ward staff throughout the patient journey - from assessment through to the procedure and beyond. There, you'll have a drip (intravenous line) put into your arm so you can have antibiotics and fluids. Visiting times are 11am–1pm and 3pm–7.30pm every day. This is a confidential service.
You can contact the ward through the main reception on 01895 823 737. Most of our patients are older and often have significant co-morbidities, making them high risk for conventional surgery. At Harefield Hospital, ask for the admissions office when you get to main reception. The test takes about 10 minutes. A CMR scan takes about an hour.
We will give you an antiseptic body wash to use before your TAVI. Your anaesthetist/doctor/nurse will discuss your general health, medicines or allergies you have, and any previous anaesthetics you've been given. Damage to the femoral (groin), or iliac artery, may need surgery, or repair using a keyhole procedure through the groin.
Then a special dye is injected through the catheter so your arteries show clearly.
Your doctor will check that the new valve is working well before removing the catheter and closing the cut in your groin, chest or shoulder.
At the annual appointment, the patient has blood tests, a review of medications, a chest X-ray, ECHO and the six-minute walk test, if appropriate.
82398; TAVI clinical nurse specialist: 020 7351 8110 or 0207 351 8371 and ask for bleep 1194; South Parade visitor accommodation: 020 7351 8044
This can occur when an artery supplying the heart (a coronary artery) gets blocked. Again, your doctor will talk this through with you. Following TAVI, around 10-20% of people will need a permanent pacemaker because their heart rhythm has not returned to normal.
A thin plastic tube (catheter) is guided through an artery in your groin or wrist to your heart.
The artery may get damaged where the catheter is inserted or where the valve is implanted.
Between 1–4% of people who have the TAVI procedure die within 30 days.
We are world famous for our expertise and have a proud history in the investigation, treatment and research of heart and lung disease.
Most people go home between two to five days after their TAVI.
One percent of people will need open heart surgery to correct complications which occur during the TAVI procedure. We are the UK's largest postgraduate specialist heart and lung centre.
Fewer than 0.01% have complications from a TOE, such as damage to their teeth, throat or gullet.
An echocardiogram uses sound waves to build up a moving picture of your heart. In intensive care and high-dependency areas, however, male and female patients may be cared for in the same bay. We are the UK's largest postgraduate specialist heart and lung centre. A walking test helps doctors see how far you can walk in six minutes. The risks include: Three percent of people have a stroke following a TAVI procedure, although strokes can can be treated with clot-busting drugs. Your doctor will discuss the risks with you before/if you decide to go ahead with a TAVI.
Male and female patients may share the same ward, but will have separate bays and bathrooms.
Most people come into hospital the day before their operation, or on the day of their TAVI, and stay for between two to five days.
It helps doctors learn more about the structure and function of your heart valves and heart chambers.
Do not eat anything on the morning of your TAVI. Support: Leah Martin, Transcatheter valve team administrator We are the UK's largest postgraduate specialist heart and lung centre. A dental check-up to make sure your teeth and gums are health can help to avoid damage during a TAVI, and reduce the risk of infection.
Your new valve is put into a catheter before the doctor guides it the it through the artery to your damaged aortic valve (Fig.
MRSA is a common infection but if you have it, we will need to treat it before your TAVI. Cath lab staff will check your identification and confirm your treatment. Transcatheter valve team (Royal Brompton Hospital) Royal Brompton has a busy transcatheter valve service, assessing and treating patients with aortic and mitral valve disease.
If you are not well enough to go to the ward, you may go to the intensive therapy unit/recovery unit. Improving your health before your TAVI can reduce the risks and help ensure your TAVI is successful. You will blow into a machine through a tube. This is called coronary angioplasty. To get more precise vision, your doctor may use X-rays, a fluoroscopy (a small x-ray film of your heart), or transoesophageal echo (TOE) to fit the new valve correctly.
Even if a TAVI is initially considered a good option, you will still be referred to a consultant cardiologist who may still do some tests.
Telephone: 020 7351 8371. The ward can be contacted through the main reception on 020 7352 8121. A CMR scan uses a magnetic field and radio waves to take pictures inside the body. Aortic stenosis is the narrowing of the aortic valve, which controls the flow of blood in and out of the heart. Before your TAVI, you'll be requested to remove all jewellry, dentures and hearing aids before undressing and putting your hospital gown on. The CNS is responsible for ensuring that these plans are given to, and discussed with, the patient and to the relevant staff. It is a nurse-led clinic that runs twice a week.
85023; Parkwood House visitor accommodation: 01895 828 823; Outpatients: 01895 828 695; Royal Brompton Hospital.
If the team agrees that a TAVI is the right treatment for.
Aortic stenosis occurs when the aortic valve narrows because it has thickened, stiffened or fused together and fails to open properly.
If there are any complications, you may need to stay in hospital a little longer. The nurse works with the MDT to plan and coordinate the procedure itself, liaising with the patient, relatives, consultants, lab staff and schedulers. We will only ask you to take this test if it is comfortable for you.
A heart monitor will continue to measure your heart rate and rhythm. © 2018 Royal Brompton & Harefield NHS Foundation Trust, Cardiology (pre-assessment) at Royal Brompton Hospital, Children's cardiac care (Royal Brompton Hospital), Familial hypercholesterolaemia (Harefield Hospital), Fitness for surgery (cardiac pre-operative), Interventional cardiology (Royal Brompton Hospital), Lipoprotein apheresis (Harefield Hospital), Mechanical circulatory (artificial heart) support, Transcatheter valve team (Royal Brompton Hospital), International nurse recruitment programme, Rapid access heart function clinic referrals.
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