Patients' experiences of everyday living before and after transcatheter aortic valve implantation

Abstract

Background Aortic stenosis (AS) is the most common valvular disease in western countries. Unless treated, it is associated with a poor prognosis. Surgical aortic valve replacement, the gold‐standard approach, aims to increase survival and improve quality of life. In recent years, though, transcatheter aortic valve implantation (TAVI) has become the treatment of choice in elderly, high‐risk patients who are denied open surgery. To date, however, little is known about their personal psychological experience after undergoing TAVI. Aim This study aimed to explore patients’ experiences during everyday life before and after TAVI. Method Altogether, 14 elderly Swedish patients (9 women, 5 men), treated with TAVI, were interviewed between 2 and 6 months after the implantation. The interviews were analysed using qualitative content analysis. Results Analysis of the participants’ experiences was divided into two domains: before and after, that is, life with AS vs. life after TAVI. From these domains, four categories were derived: (1) adapting to the deteriorating self; (2) feeling disconnected; (3) reconstruction of self; and (4) processing disappointment. Conclusions Transcatheter aortic valve implantation involves not only adding years to life but also adding life to years. The urge to live an autonomous life in a social context with others is an important argument for undergoing a TAVI procedure. Despite severe illness and demanding rehabilitation, elderly TAVI patients have the ability to regain independence and rebuild their lives when they base their decision to undergo TAVI on personal goals. These findings might be helpful when implementing person‐centred care.

Patients' motivation to undergo transcatheter aortic valve replacement. A phenomenological hermeneutic study

“…This result is similar to results from a study by Lauck et al, in which participants expressed the responsibility of not becoming a burden to others (Lauck et al, 2016 ). However, previous studies have shown that patients experience remaining physical, functional, and social limitations after TAVR (Baumbusch et al, 2018 ; Lysell & Wolf, 2021 ; Olsson et al, 2018 ; Vahanian et al, 2022 ). A large proportion of the patients who undergo TAVR have a great burden of progressive comorbidities and are often frail (Vahanian et al, 2022 ).…”

“…However, Swedish registry data reveal that multiple hospitalisations after TAVR are common (Nilsson et al, 2022 ). Still, other studies report that TAVR patients' health improved within a short time after their treatment and that they were able to take part in daily activities to a greater extent than before the procedure (Astin et al, 2017 ; Lauck et al, 2020 ; Lysell & Wolf, 2021 ). Nevertheless, remaining physical limitations are common (Arnold et al, 2017 ; Astin et al, 2017 ; Lauck et al, 2020 ; Murray et al, 2019 ) and Olsson et al did not find any difference in daily dependence after TAVR (Olsson et al, 2017 ).…”

“…However, previous studies have shown that patients experience remaining physical, functional, and social limitations after TAVR (Baumbusch et al, 2018;Lysell & Wolf, 2021;Olsson et al, 2018;Vahanian et al, 2022). A large proportion of the patients who undergo TAVR have a great burden of progressive comorbidities and are often frail (Vahanian et al, 2022).…”

Last Chance Between Life and Death: Experiences of Patients with Transcatheter Aortic Valve Implantation

“…Sonuçlarımız literatürdeki diğer kalitatif araştırmalar ile benzer çıkmıştır. [8,[13][14][15][16] Olsson ve ark. [17] yaptıkları çalışmada işlem öncesi hastaların %50'sinin nefes darlığı, %25'inin yorgunluk ve %16.7'sinin göğüs ağrısı yaşadıkları saptanmıştır.…”

“…Literatürdeki 6-12 ay aralığında yapılan takip çalışmaları bu iyilik halinin giderek artış gösterdiğini belirtmektedir. [8,9,14,15,35]…”