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Reducing TAVR Vascular Complications Through Multidisciplinary Process Optimization
Misty L Theriot1, Edward C Bergen1, J Gregory Lugo1
1Heart & Vascular Center, Lake Charles Memorial Hospital, Lake Charles, Louisiana, USA.
Insights
Implementing advanced vascular access strategies significantly reduced complications and improved efficiency in transcatheter aortic valve replacement (TAVR) procedures. This approach enhanced patient safety and streamlined recovery, leading to better outcomes.
Area of Science:
- Cardiovascular Surgery
- Medical Technology
- Health Systems Management
Background:
- Vascular complications are a significant concern in transcatheter aortic valve replacement (TAVR), impacting procedure length, recovery, and costs.
- Lake Charles Memorial Hospital observed a higher incidence of peripheral artery disease in its TAVR patients compared to national averages.
- This complex vascular anatomy contributed to increased complication rates, necessitating the development of targeted prevention strategies.
Background:
Vascular complications associated with transcatheter aortic valve replacement (TAVR) can prolong procedures, require additional interventions, extend hospital stays, delay recovery, and increase costs.
Project Rationale:
Lake Charles Memorial Hospital identified a higher prevalence of peripheral artery disease in its TAVR population, compared with national benchmarks. This increased burden of complex vascular anatomy was initially associated with higher complication rates, prompting targeted prevention strategies to improve safety and outcomes.
Project Summary:
A multidisciplinary team used root-cause analyses and iterative plan-do-study-act cycles to integrate micropuncture, ultrasound guidance, fluoroscopic road mapping, closure strategies, and enhanced staff education into standardized workflows. From 2018 to the second quarter of 2025, complication rates decreased from 11.7% to 1.9%, procedure times improved from 77 to 49 minutes, and hospital stays shortened, generating a net savings of over $86,000.
Take-Home Message:
Phased, technology-enabled access strategies, supported by a multidisciplinary team, can reduce complications and improve the efficiency of TAVR programs.
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