A Descriptive Qualitative Study of Patient and Carer Perspectives on the Acceptability of Transcatheter Aortic Valve Implantation.

AIM: To provide a structured analysis of the acceptability of transcatheter aortic valve implantation to support clinical conversations, decision making and recovery for older adults with aortic stenosis and their carers.

BACKGROUND

While transcatheter aortic valve implantation is an effective treatment for heart valve disease, its acceptability to patients and caregivers remains unclear. Understanding the acceptability of clinical procedures is key for influencing patient engagement in self-care and guiding the information and support patients and carers need.

DESIGN

A descriptive, qualitative study used deductive content analysis, guided by Sekhon's Theoretical Framework of Acceptability.

METHODS

Participants included 18 aortic stenosis patients (mean age 84.2 ± 4.1 years) and 8 carers from three Australian metropolitan hospitals (2018-2020). Semi-structured interviews were conducted 4-6 months post-TAVI and transcribed verbatim. Analysis used Sekhon's Theoretical Framework of Acceptability across three temporal zones, with deductive coding examining affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self-efficacy.

RESULTS

Participants described high prospective, concurrent and retrospective acceptability of transcatheter aortic valve implantation. Perceived prospective acceptability framed the procedure as lifesaving. Peri-operatively, participants found the procedure simple, low-risk and minimally disruptive, ensuring high concurrent acceptability. Post-procedure, patient participants described a slow but gradual return to normal, growing confidence and a reengagement with their valued pastimes. The absence of structured rehabilitation advice led to self-designed recoveries and uncertainty about safe limits.

CONCLUSION

Transcatheter aortic valve implantation was perceived as a highly acceptable intervention that helped this group of mostly older adults achieve their personal goals.

RELEVANCE TO CLINICAL PRACTICE: Despite the minimally invasive nature of transcatheter aortic valve replacement, optimising recovery and rehabilitation requires a holistic approach that addresses both clinical needs and patient goals.

PATIENT AND PUBLIC CONTRIBUTION: None in the conceptualisation or design.