The implementation of a streamlined TAVI patient pathway across five European countries: BENCHMARK registry
Status Publisher Language English Country Germany Media print-electronic
Document type Journal Article
PubMed
40261426
DOI
10.1007/s00392-025-02638-z
PII: 10.1007/s00392-025-02638-z
Knihovny.cz E-resources
- Keywords
- Aortic stenosis, Clinical care, Prospective registry, Quality of care, TAVI, Transcatheter aortic valve implantation,
- Publication type
- Journal Article MeSH
BACKGROUND: Benchmark best practices have been shown to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI), but the impact in diverse health systems is unknown. AIMS: We evaluated the impact of Benchmark best practices implementation in Germany, Austria, France, Spain, and Italy. METHODS: International, multicentre registry of severe symptomatic aortic stenosis (AS) patients undergoing TAVI with a balloon-expandable valve, before and after Benchmark best practices implementation. Objectives were to reduce overall and intensive care unit (ICU) length of stay (LoS), and to document 30-day safety. RESULTS: A total of 890 patients were analysed in France, 454 in Spain, 362 in Germany, 300 in Italy, and 176 in Austria. Patients had the highest surgical risk in Germany (EuroSCORE II 6.8 ± 7.3%) and lowest in Spain (3.8 ± 2.6%). Austrian patients reported higher rates of prior myocardial infarction, severe pulmonary hypertension, and aortic valve-related symptoms at baseline. After the implementation of Benchmark best practices, the median hospital LoS was significantly reduced in France (5 vs. 3 days, p < 0.001), Spain (6 vs. 4, p < 0.001), Germany (9 vs. 6, p < 0.001), and Italy (7 vs. 5, p < 0.001); reductions in median ICU LoS were reported in France (1.1 vs. 0 days, p < 0.001), Spain (1.9 vs. 1, p < 0.001), and Germany (1 vs. 0.9, p = 0.004). Across all countries, 30-day safety outcomes were uncompromised and reduced rates of major vascular complications rates were observed in Germany (5.9 vs. 0.0%, p < 0.001). CONCLUSION: The implementation of Benchmark best practices in diverse European healthcare systems resulted in reduced hospital and ICU LoS without compromising patient safety. TRIAL REGISTRATION: ClinicalTrials.gov NCT04579445, September 28th, 2020.
Cardiac Center IKEM Prague Prague Czech Republic
Cardiology Besancon Regional University Hospital Center Besancon France
Cardiology Department Hospital Regional Universitario de Málaga Malaga Spain
Cardiology Department Hospital Sindelfingen Böblingen Sindelfingen Germany
Cardiology Department Hospital Universitari Son Espases Palma Spain
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 Division AO Ordine Mauriziano Turin Italy
Cardiology Polyclinique Du Bois Lille France
Centre for Cardiovascular Innovation University of British Columbia Vancouver BC Canada
Centro Cardiologico Monzino IRCCS Milan Italy
CHU Rennes Service de Cardiologie Inserm LTSI U1099 Université de Rennes 1 Rennes France
Department de Cardiologie Hôpital de Pitié Salpêtrière AP HP Paris France
Department for Cardiovascular Surgery Artemed Klinikum München Munich Germany
Department of Cardiac Surgery Paracelsus Medical University Nuremberg Germany
Department of Cardiology and Pulmonology Georg August University Göttingen Germany
Department of Cardiology Institut Mutualiste Montsouris Paris France
Department of Cardiology Policlinico S Orsola Malpighi University of Bologna Bologna Italy
Department of Cardiology The Clinique de L'Infirmerie Protestante Lyon France
Department of Cardiology University Hospital of Rouen Rouen France
Department of Internal Medicine 3 Cardiology University Hospital St Pölten St Pölten Austria
Department of Internal Medicine 3 Kiel Germany
Department of Interventional Cardiology Hôpital Saint Joseph Marseille France
Edwards Lifesciences Prague Czech Republic
Institute for Pharmacology and Preventive Medicine Cloppenburg Germany
Medical Department 3 Heart Center Trier Krankenhaus der Barmherzigen Brüder Trier Germany
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ClinicalTrials.gov
NCT04579445
