A streamlined pathway for transcatheter aortic valve implantation: the BENCHMARK study

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Healthcare Management

Background:

• Transcatheter aortic valve implantation (TAVI) offers significant potential for clinical pathway optimization.
• Severe symptomatic aortic stenosis (AS) necessitates efficient and safe treatment strategies.

Purpose of the Study:

• To evaluate the impact of BENCHMARK best practices on TAVI efficiency and safety.
• To assess changes in length of stay (LoS) and intensive care unit (ICU) duration post-BENCHMARK implementation.

Main Methods:

• A multi-center study across 7 European countries involving 28 sites.
• Comparison of TAVI outcomes in patients before and after adopting BENCHMARK best practices.
• Focus on balloon-expandable valves for severe symptomatic aortic stenosis (AS).

Main Results:

• Reduced mean LoS from 7.7 to 5.8 days (P < .001) and ICU stay from 1.8 to 1.3 days (P < .001).
• Increased local anesthesia use (96.1% vs. 84.3%) and decreased procedure/intervention times.
• No compromise in 30-day safety outcomes, including all-cause mortality (0.6%), stroke (1.4%), and bleeding (1.3%).

Conclusions:

• Broad implementation of BENCHMARK practices enhances TAVI pathway efficiency.
• Reduced LoS and associated costs are achievable without compromising patient safety.
• BENCHMARK practices represent a valuable strategy for optimizing TAVI care delivery.