A streamlined pathway for transcatheter aortic valve implantation

Background and There is significant potential to streamline the clinical pathway for patients undergoing transcatheter aortic valve implant-Aims ation (TAVI). The purpose of this study was to evaluate the effect of implementing BENCHMARK best practices on the efficiency and safety of TAVI in 28 site...

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Detalles Bibliográficos
Autores: Frank, Derk|||0000-0001-7561-075X, Durand, Eric|||0000-0001-8171-7959, Lauck, Sandra|||0000-0002-0181-559X, Muir, Douglas F.|||0000-0003-1871-2869, Spence, Mark, Vasa-Nicotera, Mariuca, Wood, David, Saia, Francesco|||0000-0001-9969-2649, Urbano-Carrillo, Cristóbal A.|||0000-0002-9504-8861, Bouchayer, Damien, Iliescu, Vlad Anton|||0000-0002-7290-3300, Etienne, Christophe Saint, Leclercq, Florence|||0000-0001-5936-5184, Auffret, Vincent|||0000-0002-9481-646X, Asmarats, Lluís|||0000-0002-3357-5834, Di Mario, Carlo|||0000-0002-4461-2055, Veugeois, Aurelie, Maly, Jiri|||0000-0002-7863-245X, Schober, Andreas|||0000-0003-1410-6108, Nombela-Franco, Luís|||0000-0003-3438-8907, Werner, Nikos, Gómez-Hospital, Joan Antoni|||0000-0002-3249-3095, Mascherbauer, J.|||0000-0001-7478-1450, Musumeci, Giuseppe|||0000-0001-6016-5702, Meneveau, Nicolas|||0000-0002-1017-0463, Meurice, Thibaud, Mahfoud, Felix|||0000-0002-4425-549X, De Marco, Federico|||0000-0003-3554-6938, Seidler, Tim|||0000-0002-6158-5087, Leuschner, Florian|||0000-0003-1157-474X, Joly, Patrick, Collet, Jean-Philippe|||0000-0003-3750-5347, Vogt, Ferdinand|||0000-0002-1924-6823, Di Lorenzo, Emilio, Kuhn, Elmar|||0000-0001-6301-7422, Disdier, Vicente Peral|||0000-0003-0379-5243, Hachaturyan, Violetta|||0000-0002-0279-3476, Lüske, Claudia M.|||0000-0001-7084-0628, Rakova, Radka, Wesselink, Wilbert|||0000-0001-6494-2919, Kurucova, Jana, Bramlage, Peter|||0000-0003-4970-2110, McCalmont, Gemma|||0000-0001-6322-072X, Frank, D., Lüske, C.M., Zielinski, M., Greinert, D., Deutsch, Cornelia, Hachaturyan, V., Durand, E., Lauck, S., Muir, D., Spence, M., Vasa-Nicotera, M., Wood, D., Saia, F., Kurucova, J., Wesselink, W., Rakova, R., Thoenes, M., Urbano-Carrillo, C.A., García, C.L., Chamorro, B., Bouchayer, D., Claudel, J.P., Perrier, H., Frebault, V., Parasca, C.A., Etienne, C.S., Lassouani, K., Leclercq, F., Zitouni, W., Soltani, S., Auffret, V., Le Gal, R., Xarrie, E.J., Di Mario, C., Ciardetti, N., Meucci, F., Veugeois, A., Bagdadi, I., Maly, J., Kolinova, L., Schober, A., Delle-Karth, Georg, Schuster, C., Leitgeb, M.C., Nombela-Franco, L., García, E.B., Pozzi, M.A.O., Werner, N., Leick, J., Lauterbach, M., Waschbüsch, H., Gómez-Hospital, J.A., Muntané Carol, Guillem, Daxböck, J.M.O., Butkovic, M., Popescu, S., Musumeci, G., Perrero, M., Meneveau, N., Watbled, S., Meurice, T., Delomez, M., Mahfoud, F., Scheller, B., Ewen, S., Berger, A.K., Koch, Christian|||0000-0002-2655-7363, Engel, A., De Marco, F., Olivares, P., Seidler, T., Wolf, F., Müller, Claudia, Hünermund, M., Leuschner, F., Konstandin, M., Linz, L., Ulbricht, Hannah, Siame, S., Amrane, N.A., Vogt, F., Rosenzweig, D., Di Lorenzo, E., Cefalo, B., Kuhn, E., Wolf, V., Disdier, V.P., Daunert, J.M., de la Bandera Sanchez, M.C.
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:305889
Acceso en línea:https://ddd.uab.cat/record/305889
https://dx.doi.org/urn:doi:10.1093/eurheartj/ehae147
Access Level:acceso abierto
Palabra clave:Aortic stenosis
Clinical care
Health services
Prospective registry
Quality of care
TAVI
Transcatheter aortic valve implantation
Descripción
Sumario:Background and There is significant potential to streamline the clinical pathway for patients undergoing transcatheter aortic valve implant-Aims ation (TAVI). The purpose of this study was to evaluate the effect of implementing BENCHMARK best practices on the efficiency and safety of TAVI in 28 sites in 7 European countries. Methods This was a study of patients with severe symptomatic aortic stenosis (AS) undergoing TAVI with balloon-expandable valves before and after implementation of BENCHMARK best practices. Principal objectives were to reduce hospital length of stay (LoS) and duration of intensive care stay. Secondary objective was to document patient safety. Results Between January 2020 and March 2023, 897 patients were documented prior to and 1491 patients after the implementation of BENCHMARK practices. Patient characteristics were consistent with a known older TAVI population and only minor differences. Mean LoS was reduced from 7.7 ± 7.0 to 5.8 ± 5.6 days (median 6 vs. 4 days; P <.001). Duration of intensive care was reduced from 1.8 to 1.3 days (median 1.1 vs. 0.9 days; P <.001). Adoption of peri-procedure best practices led to increased use of local anaesthesia (96.1% vs. 84.3%; P <.001) and decreased procedure (median 47 vs. 60 min; P <.001) and intervention times (85 vs. 95 min; P <.001). Thirty-day patient safety did not appear to be compromised with no differences in all-cause mortality (0.6% in both groups combined), stroke/transient ischaemic attack (1.4%), life-threatening bleeding (1.3%), stage 2/3 acute kidney injury (0.7%), and valve-related readmission (1.2%). Conclusions Broad implementation of BENCHMARK practices contributes to improving efficiency of TAVI pathway reducing LoS and costs without compromising patient safety.

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