Safe Recovery After Transcatheter Heart Valve Procedures

Abstract

Care of patients undergoing transcatheter heart valve (THV) procedures has evolved dramatically over the last decade. Post-procedure care has moved from recovery following a surgical operation to recovery from a minimally invasive, percutaneous procedure. Enhanced recovery protocols based on phase of care criteria have helped reshape post-procedure care. Smaller catheters and radiographic devices with transcatheter valve procedures have facilitated adoption of a “minimalist process” embracing conscious sedation, early discontinuation of central lines, elimination of urinary catheters, nurse driven protocols for early mobilization, shorter length of stay, and higher discharge to home rates. Although valve procedures requiring transseptal crossings still require use of trans-esophageal guidance and intubation, lessons learned from the minimally invasive approach have crossed over allowing for facilitated recovery and earlier discharge. As knowledge regarding the post-procedure period has increased, care has been streamlined, become less complex, allowed earlier discharge and higher rates of discharge to home and lower complication rates.