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A streamlined pathway for transcatheter aortic valve implantation: the BENCHMARK study
D. Frank, E. Durand, S. Lauck, DF. Muir, M. Spence, M. Vasa-Nicotera, D. Wood, F. Saia, CA. Urbano-Carrillo, D. Bouchayer, VA. Iliescu, C. Saint Etienne, F. Leclercq, V. Auffret, L. Asmarats, C. Di Mario, A. Veugeois, J. Maly, A. Schober, L....
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
Grant support
Institute for Pharmacology and Preventive Medicine GmbH
Edwards Lifesciences and performed under the sponsorship of IPPMed
NLK
Free Medical Journals
from 1996 to 1 year ago
Open Access Digital Library
from 1996-01-01
- MeSH
- Aortic Valve Stenosis * surgery MeSH
- Benchmarking * MeSH
- Patient Safety MeSH
- Length of Stay * statistics & numerical data MeSH
- Critical Pathways MeSH
- Humans MeSH
- Postoperative Complications epidemiology prevention & control MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Transcatheter Aortic Valve Replacement * methods MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
BACKGROUND AND AIMS: There is significant potential to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (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.
Cardiac Center IKEM Prague Prague Czech Republic
Cardiology Besancon Regional University Hospital Center Besancon France
Cardiology Centro Cardiologico Monzino Milan Italy
Cardiology Department Hospital Regional Universitario de Málaga Malaga Spain
Cardiology Department Hospital Sindelfingen Böblingen Sindelfingen Germany
Cardiology Department James Cook University Hospital Middlesbrough UK
Cardiology Department Mater Private Network Dublin Ireland
Cardiology Department Montpellier University Hospital Montpellier University Montpellier France
Cardiology Department University Hospital Son Espases Palma de Mallorca Spain
Cardiology Polyclinique Du Bois Lille France
Centre for Cardiovascular Innovation University of British Columbia Vancouver BC Canada
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares Madrid Spain
Department de Cardiologie Hôpital de Pitié Salpêtrière AP HP Paris France
Department for Cardiovascular Surgery Artemed Klinikum München München Germany
Department of Cardiology and Pulmonology Georg August University Göttingen Germany
Department of Cardiology Hospital Floridsdorf Vienna Austria
Department of Cardiology Institut Mutualiste Montsouris Paris France
Department of Cardiology Kerckhoff Klinik Bad Nauheim Germany
Department of Cardiology The Clinique de l'Infirmerie Protestante Lyon France
Department of Cardiology Univ Rouen Normandie Inserm U1096 CHU Rouen Rouen France
Department of Cardiology University Medicine Göttingen Heart Center Göttingen Germany
Department of Cardiology University of Bologna Policlinico S Orsola Malpighi Bologna Italy
Department of Cardiology University of Medicine and Pharmacy Carol Davila Bucharest Romania
Department of Internal Medicine 3 Arnold Heller Strasse 3 Haus K3 Kiel 24105 Germany
Department of Internal Medicine 3 Cardiology University Hospital St Pölten St Pölten Austria
Department of Interventional Cardiology Hôpital Saint Joseph Marseille France
Edwards Lifesciences Nyon Switzerland
Edwards Lifesciences Prague Czech Republic
Institute for Pharmacology and Preventive Medicine Cloppenburg Germany
Karl Landsteiner Institute for Cardiovascular and Critical Care Research Vienna Vienna Austria
Medical Department 3 Heart Center Trier Krankenhaus der Barmherzigen Brüder Trier Germany
Struttura Complessa of Cardiology Ospedale Mauriziano Torino Italy
Université de Rennes 1 CHU Rennes Service de Cardiologie Inserm LTSI U1099 Rennes France
References provided by Crossref.org
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