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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Related Experiment Video

Updated: Jul 17, 2025

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Time to TAVI: streamlining the pathway to treatment.

Lynsey Jane Hewitson1, Suzane Cadiz2, Sameeha Al-Sayed2

  • 1Great Western Hospitals NHS Foundation Trust, Swindon, UK lynsey.hewitson@nhs.net.

Open Heart
|September 4, 2023
PubMed
Summary

A new transcatheter aortic valve implantation (TAVI) pathway streamlines patient workup locally, significantly reducing treatment delays and improving TAVI acceptance rates. This approach enhances access to TAVI for severe aortic stenosis patients.

Keywords:
Aortic Valve StenosisDelivery of Health CareDiagnostic ImagingEpidemiologyTranscatheter Aortic Valve Replacement

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Health Services Research

Background:

  • Severe aortic stenosis poses significant morbidity and mortality risks.
  • Traditional transcatheter aortic valve implantation (TAVI) pathways rely on tertiary Heart Valve Centres, often causing treatment delays.
  • Existing delays breach British Cardiovascular Intervention Society targets, necessitating pathway optimization.

Purpose of the Study:

  • To evaluate a novel TAVI referral pathway emphasizing local comprehensive patient workup.
  • To assess the impact of this new pathway on time to TAVI and referral acceptance rates.
  • To determine if local workup improves TAVI accessibility.

Main Methods:

  • Retrospective data collection of TAVI referrals from November 2020 to November 2021.
  • Comparison of time from referral to TAVI between a center with a novel local workup pathway and traditional pathways.
  • Analysis of total pathway time (echocardiographic diagnosis to TAVI) for the novel pathway.
  • Secondary analysis of referral acceptance rates for TAVI.

Main Results:

  • The novel pathway significantly reduced the mean time from referral to TAVI (32.4 days vs. 126 days, p<0.00001).
  • Total pathway time from diagnosis to TAVI was significantly shorter (89.9 days) compared to traditional referral times (p<0.003).
  • Referral acceptance rates for TAVI were substantially higher in the novel pathway (97.8% vs. 49.5%, p<0.00001).

Conclusions:

  • A TAVI pathway with local workup in non-surgical centers significantly decreases TAVI procedural time and rejection rates.
  • This optimized pathway improves patient access to TAVI.
  • Widespread adoption of this approach could enhance TAVI accessibility across centers.