Background/Objectives: Multidisciplinary TAVI programs are focused on improving patient-centred care. We compared outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) within a multidisciplinary programme including a nurse with those of patients in the standard programme. Methods: This single-centre observational retrospective study includes patients with severe aortic valve disease and a TAVI indication, with the goal of comparing a nurse programme with standard practice. In the TAVI nursing programme, the nurse has several key roles: patient and family education, comprehensive assessment and procedure planification, patient and family accompaniment, complications detection during admission and follow-up, and patient experience evaluation in the post-procedure period. Results: 154 patients were included: 87 in the nurse programme and 67 in standard practice groups, respectively. Men comprised 52.6%, with an average age of 81 years. Both groups achieved high procedure success without differences in mortality during admission and follow-up (median 13.4 months). The nurse programme group showed better functional class more frequently and had significantly fewer emergency department visits (11.8% vs. 31.3%) and less frequency of readmission (1.2% vs. 23.4%). The TAVI nurse group reported significantly higher overall satisfaction with the process (9.8 vs. 8.9 scores), with the information received and the nurse treatment being the best rated items. Conclusions: A multidisciplinary programme for patients undergoing TAVI, coordinated by nurses and based on comprehensive attention that places the patients at the centre of the process, is feasible and shows high patient satisfaction.

Background Transcatheter Aortic Valve Implantation (TAVI) has changed the treatment paradigm of the aortic stenosis (AS). It has become the treatment of choice in patients with symptomatic AS and surgical high risk, and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk. Despite numerous evidence on clinical results, indications and benefits, only a few studies analyse it from patient’s perspective and the impact of TAVI on them. The objective of this study is to evaluate the experience of patients undergoing TAVI. Methods Cross-sectional, descriptive observational study in two Spanish hospitals, with a establish Nurse TAVI program, with 100 patients undergoing TAVI. A specific questionnaire was designed (VALVEX questionnaire) and a pilot study was conducted by a multidisciplinary team of doctors, nurses and patients. The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic. Results The study demonstrated a mean satisfaction of 9 for the TAVI program, with 96% of patients that would recommend TAVI to other patients. Patients scored a high satisfaction on the information received prior to the procedure. During the procedure and admission, the satisfaction was high in relation to the care received. During the follow up, satisfaction was high in relation to the role of the TAVI nurse, for the information and continuation of care during the procedure, in reducing anxiety, organising their admission and understanding the process. However, questions with less scores were related to hospital catering, delay between diagnosed and treatment, and patient decision-making process. Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax, aware and prepared for the procedure. Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient’s satisfaction. The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.

Progression of aortic stenosis (AS) is aggravated by type 2 Diabetes Mellitus (T2DM) and kidney dysfunction (KD). Oxidative stress is one of the main mechanisms that triggers AS and is also disturbed among subjects with T2DM and KD. Consequently, we studied the redox homeostasis in four groups of patients, also classifying each patient based on their kidney function: control subjects, T2DM, AS, and AS+T2DM. Free reduced thiols in plasma were analyzed using a colorimetric assay, and the redox state of human serum albumin (HSA) was assessed by immunodetection and PEG-PCMal labeling. Lower levels of thiols were evident in patients with AS and AS+T2DM, while reduced and mildly oxidized HSA was more abundant in T2DM and AS+T2DM patients, reflecting less protection against oxidation. Moreover, the thiol levels decreased as KD increased in patients with AS and AS+T2DM. Differences also exist in reduced and mildly oxidized HSA between patients with normal and severely impaired kidney function, whereas AS patients with severe KD had more strongly oxidized HSA. Our results confirm an imbalance in oxidative stress associated with AS that is aggravated by the coexistence of T2DM and KD. Moreover, T2DM treatment might mitigate this dysfunction, opening the door to new therapeutic approaches for these patients.

Background and Objectives: Degenerative aortic stenosis has become the most common primary valve lesion referred for intervention, with thousands of transcatheter aortic valve implantation (TAVI) procedures being performed annually. To date, there are no quantitative tools capable of evaluating patient experience adapted to percutaneous procedures of this nature. The goal of this study is to propose and validate the VALVEX questionnaire as the reference tool to assess patient experience throughout the TAVI process and to identify areas for improvement in healthcare. Methods: This was a cross-sectional observational study with a 30-day follow-up that included consecutive patients > 18 years of age undergoing elective TAVI in two Spanish hospitals. A multidisciplinary panel including patients was constituted to design, refine, and pilot the VALVEX questionnaire. During its completion 30 days after the procedure, the dimensions assessed were the care provided before, during, and after TAVI, as well as the facilities and overall patient satisfaction. Reliability, validity, and feasibility were analysed during the validation phase. Results: A total of 335 patients were enrolled and filled out the VALVEX questionnaire (mean age 81.1 ± 5 years, 52% female). Evaluation of feasibility showed a mean completion time of 7.8 ± 2.3 min, with a 2.1% rate of unanswered questions. Cronbach’s alpha index was 0.912, with high internal reliability measurements for all the assessed dimensions. An intraclass correlation coefficient (ICC) of 0.851 was determined as an indicator of stability. The Delphi panel achieved a consensus of over 85% in clarity, coherence, relevance, and sufficiency. Conclusions: We have successfully validated the VALVEX questionnaire as the first quantitative tool specifically designed to measure and evaluate patient experience throughout the TAVI procedure and recovery. This questionnaire is a valid, reliable, simple, and easy-to-use resource that could be used as a reference tool to assess patient experience for TAVI or other percutaneous cardiac interventions.

Introducción: el estudio MAREC Críticos forma parte del Proyecto MAREC de la Asociación Española de Enfermería en Cardiología como iniciativa del grupo de cuidados críticos cardiovasculares. Tiene como objetivo describir los recursos y la organización de las unidades de cuidados críticos cardiovasculares en España, con el fin de conocer la situación real de las enfermeras en este ámbito. Material y métodos: se trata de un estudio observacional, descriptivo y multicéntrico, realizado entre noviembre de 2022 y marzo de 2024, que incluyó hospitales públicos y privados con atención a pacientes críticos cardiovasculares. Se diseñó un cuestionario estructurado con 129 preguntas, abarcando aspectos organizativos, recursos humanos, formación y dotación tecnológica. Resultados: los resultados muestran una gran heterogeneidad en la denominación, organización y dependencia médica de las unidades de cuidados críticos cardiovasculares, con una ratio enfermera-paciente entre 1:2-1:3 en el 44,2% de las unidades, pero siendo variable entre turnos y los fines de semana. El 69% de las unidades carecían de un sistema de medición de carga laboral y el 55,8% no disponían de un programa formativo específico en cuidados críticos. La presencia de enfermeras con formación avanzada (máster en cardiología/cuidados críticos) o doctorado fue escasa, limitando el desarrollo profesional e investigador. Conclusiones: el estudio destaca la existencia de una gran diferencia de recursos y organizaciones entre las distintas unidades de cuidados críticos cardiovasculares de España planteando la necesidad de unificar criterios en formación, contratación y dotación de personal para garantizar una atención segura y eficaz. Palabras clave: Enfermería cardiovascular, Enfermería de cuidados críticos, Capacitación profesional, Recursos en salud, Unidades de cuidados coronarios, Enfermedades cardio­vasculares. Introduction: The MAREC critical study is part of the MAREC Project of the Spanish Association of Nursing in Cardiology as an initiative of the Cardiovascular Critical Care Group. Its objective is to describe the resources and organization of Cardiovascular Critical Care Units in Spain, with the aim of understanding the current situation of nurses in this field. Material and Methods: This is an observational, descriptive, and multicenter study conducted between November 2022 and March 2024, which included both public and private hospitals providing care to critical cardiovascular patients. A structured questionnaire with 129 questions was designed, covering organizational aspects, human resources, training, and technological equipment. Results: The results reveal significant heterogeneity in the naming, organization, and medical dependency of the Cardiovascular Critical Care Units, with a nurse-patient ratio of 1:2 to 1:3 in 44.2% of the units, although this varies between shifts and weekends. Additionally, 69% of the units lacked a workload measurement system, and 55.8% did not have a specific training program for critical care. The presence of nurses with advanced training (master's in cardiology/critical care) or doctoral degrees was limited, restricting professional and research development. Conclusions: The study highlights the significant differences in resources and organization among the different Cardiovascular Critical Care Units in Spain, emphasizing the need to unify criteria for training, recruitment, and staffing to ensure safe and effective care. Keywords: Cardiovascular Nursing, Critical Care Nursing, Professional Training, Health resources, Coronary Care Units, Cardiovascular Diseases.

Background: The Coronavirus disease 19 (COVID-19) pandemic has impacted clinical practice with important changes in the most affected areas, resulting in increased mortality from heart disease (myocardial infarction). Our objective was to analyze the feasibility of continuing a temporary mechanical circulatory support (MCS) program survival during COVID-19 pandemic. Methods: Retrospective study including all veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and Impella CP® implants in a referral hospital since March 2020 to February 2021. They were compared to previous implants results. Results: Out of 175 short-term MCS implanted from 2013, 33 (18.9%) were conducted during the time of COVID-19 pandemic: 24 VA-ECMO and 9 Impella CP®. Compared to preCOVID-19 implants, patients in COVID-19 era presented worst left ventricular ejection fraction (16.5 [21]% vs 25 [21]%, p=0.018), more frequently right ventricular dysfunction (72.7% vs. 48.6%, p=0.022), without other significant differences regarding the baseline situation and implant technique. Post anoxic encephalopathy was more frequent in COVID-19 era. Survival at discharge was similar in the pre-COVID era (43.7%) and during pandemic (39.4%) (p=0.700). Conclusions: Survival after temporary MCS did not get worse significantly during the COVID-19 pandemic. The possibility of short-term MCS should be maintained for cardiogenic shock and other cases of hemodynamic instability.