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Education, and obtaining of informed consent, using multimedia before adults with congenitally malformed hearts are submitted to transcatheter interventions

Published online by Cambridge University Press:  23 December 2008

Gianluca Rigatelli ,
Beatrice Magro ,
Susanna Ferro ,
Emiliano Bedendo ,
Sandra Cominato ,
Riccardo Mantovan ,
Laura Oliva ,
Massimo Giordan ,
Fabio Dell’Avvocata  and
Paolo Cardaioli
Gianluca Rigatelli*
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Beatrice Magro
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Susanna Ferro
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Emiliano Bedendo
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Sandra Cominato
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Riccardo Mantovan
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Laura Oliva
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Massimo Giordan
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Fabio Dell’Avvocata
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Paolo Cardaioli
Affiliation:
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
*
Correspondence to: Gianluca Rigatelli, MD, FACP, FACC, FESC, FSCAI, Via Mozart 9, 37048 Legnago, Verona-Italy. Tel: +390 3471912016; Fax: +390 44220164; E-mail: jackyheart@libero.it
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Abstract

Background

Multimedia programmes relating to education and consents may be useful for decreasing anxiety during catheter-based repair in patients with congenitally malformed hearts.

Objective

Our study was aimed at evaluating the impact of multimedia protocols for education of a population of consecutive patients with congenitally malformed hearts prior to transcatheter repair.

Methods

Between September, 2006, and May, 2008, we enrolled 100 consecutive patients, with a mean age of 45 ± 19 years, of whom 69 were female, for catheter-based repair of their congenitally malformed hearts. In the first 50 patients, we used a written form for informed consent sent to the patients 15 days before the procedure, coupled with a personal interview of 30 minutes. In the subsequent 50 patients, we used multimedia protocol for education, comprising a booklet of 4 pages containing a simple and brief explanation of the intervention, and a digital film of 4 minutes showing the transcatheter procedure with a commentary provided by the referring physician, prior to obtaining the signature for informed consent. We then compared the scores for anxiety, the pre-operative heart rate, the frequency of vaso-vagal episodes, and the need for conscious sedation between the two groups.

Results

Patients who underwent preconditioning using the multimedia programme were significantly less anxious, and had significantly lower heart rates. Vaso-vagal episodes were also significantly less in this group, with no episodes compared to 14% in those providing standard informed consent. Conscious sedation was needed more frequently in those providing standard informed consent.

Conclusion

Our brief study suggests that a comprehensive multimedia programme of preparation increases the tolerability, and decrease the emotional state, of adults about to undergo catheter-based interventions for congenital cardiac disease.

Keywords

Interventional cardiologyatrial septal defectdevice
Type
Original Article
Information
Cardiology in the Young , Volume 19 , Issue 1 , February 2009 , pp. 60 - 63
Copyright
Copyright © Cambridge University Press 2008

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