ASSESSMENT OF FUNCTIONAL STATUS IN PATIENTS WITH SEVERE AORTIC STENOSIS AFTER TRANSCHATETER AORTIC VALVE IMPLANTATION

UVOD: aortalna stenoza je (AS) je najčešća valvularna bolest koja pogađa 3% svjetske populacije starije od 65 godina i jedna je od značajnijih valvularnih bolesti u razvijenim zem-ljama (1). S obzirom da lijekovi još uvijek daju slabe rezultate u liječenju AS (2) zamjena aortne valvule je najvažniji korak u liječenju simptomatskih bolesnika (3). CILJ ISTRAŽIVANJA: procijeniti funkcionalni status bolesnika nakon primjene TAVI-a prema NYHA klasifikaciji, zatim istražiti utjecaj spola i dobi na ishod zahvata te utjecaj zah-vata na parametar ehokardiografije (EF). METODE: istraživanje je retrospektivno i provedeno je na 67 pacijenata koji su hospitalizi-rani u KBC-u Rijeka u periodu od 01.01.2016. do 01.01.2020. godine, zbog teške aortalne stenoze za koji je kardiološki tim procijenio potrebu za TAVI zahvatom. U istraživanju se obrađivao funkcionalni status bolesnika pomoću ljestvice za procjenu funkcionalnog statusa- NYHA klasifikacija i ehokardiografski nalaz prije i poslije TAVI-a, te utjecaj dobi i spola na ishod zahvata analizom bolničke dokumentacije, kroz IBIS REZULTATI:od ukupnog broja bolesnika 67 (100%), sudjelovalo je 35 žena (52%) i 32 muškarca (48%), prosječne dobi za muškarce 77,9 ± 7,6 te za žene 80,57 ± 4,43 godina. Ispi-tanici su prije zahvata imali razinu NYHA klasifikacije 3-4, dok je nakon zahvata razina NYHA klasifikacije 1. Ispitanicima prije zahvata medijan EF je 50%, a isti je medijan EF ispitanika i nakon zahvata. Podaci su obrađeni pomoću deskriptivne i inferencijalne statistike. ZAKLJUČAK: testiranjem hipoteza u ovom istraživanju, došlo se do zaključka da bolesnici s teškom AS, nakon primjene TAVI zahvata, imaju poboljšani funkcionalni status prema NYHA klasifikaciji, da dob i spol ne utječu na ishod zahvata te da bolesnici imaju isti stupanj EF kao i prije zahvata. Ovim istraživanjem, osim istraživanja pozitivnog učinka zahvata TA-VI na bolesnike koji boluju od teške AS, prikazana je i nezamjenjiva uloga medicinske sestre u cjelokupnom procesu.INTRODUCTION: Aortic stenosis (AS) is the most common valvular disease that affects 3% of the world's population over the age of 65 years and is one of the most significant valvular diseases in developed countries (1). Since the drugs still produce poor results in the treatment of AS (2) replacement of aortic valve is the most important step in the treatment of sympto-matic patients (3). RESEARCH OBJECTIVE: to assess the functional status of patients after administration of TAVI according to the NYHA classification, then investigate the influence of sex and age on the outcome of the procedure and the influence of procedure on echocardiography parameter (EF). METHODS: The study was retrospectively and was conducted on 67 patients who were hos-pitalized at the Hospital Rijeka in the period from 01.01.2016. to 01.01.2020, due to severe aortic stenosis for which the cardiology team assessed the need for TAVI procedure. In the study, the functional status of patients was processed using the functional status assessment scale- NYHA classification and echocardiographic finding before and after TAVI, and the influence of age and gender on the outcome of the procedure by analysing hospital documen-tation, through IBIS. RESULTS: out of the total number of patients 67 (100%), 35 women (52%) participated and 32 males (48%), mean men 77.9 ± 7.6 years and 80.57 ± 4.43 years for women. Subjects had a NYHA classification level of 3-4 prior to the procedure, while after the procedure, NYHA class level was 1. Subjects prior to the procedure, the median EF is 50%, and the same is the median EF of subjects after the procedure. The data was processed using descriptive and infe-rencing statistics. CONCLUSION: by testing the hypothesis in this study, it has come to the conclusion that patients with severe AS, after administration of the TAVI procedure, have improved functio-nal status according to the NYHA classification, that age and gender do not affect the outco-me of the procedure and that patients have the same degree of EF as before the procedure. This study, in addition to researching the positive effect of TAVI surgery on patients with severe AS, also presents the irreplaceable role of the nurse in the overall process