Clinical Process Optimization of Transfemoral Transcatheter Aortic Valve Implantation

Figures & data

Figure 1. Flow chart including the implementation of a transcatheter aortic valve implantation coordinator since 2016 aiming for an earlier pre-assessment of potential transcatheter aortic valve implantation candidates.

TAVI: Transcatheter aortic valve implantation.

Table 1. Patient demographics.

	2014/2015 (n = 203)	2016/2017 (n = 260)	p-value
Age (years)	81.1 ± 6.0	82.1 ± 4.8	0.034^†
Men	96 (47)	127 (49)	0.740
EuroScore I, logistic	19.7 ± 13.1	21.1 ± 13.1	0.248
Ejection fraction	49.5 ± 9.4	49.3 ± 10.5	0.845
Prognosis limiting disease^‡	19 (9)	21 (8)	0.626
Hostile aorta	25 (12)	21 (8)	0.130
Previous cardiovascular surgery	25 (12)	39 (15)	0.406
Carotid artery disease	51 (25)	55 (21)	0.313
Chronic lung disease	32 (16)	46 (18)	0.582
Coronary artery disease	40 (20)	48 (18)	0.735
Peripheral artery disease	116 (57)	157 (60)	0.482

Data are presented as mean ± standard deviation or n (%).

† Significant.

‡ Prognosis-limiting disease indicates a life expectancy of <1 year.

Table 2. Comparison of main relevant examinations covering pretranscatheter aortic valve implantation inpatient stay between 2014/2015 and 2016/2017.

	2014/2015 (n = 203), n (%)	2016/2017 (n = 260), n (%)	p-value
PCI during hospitalization	36 (18)	35 (13)	0.206
Examination before inpatient stay^†
– Coronary angiography	97 (48)	133 (51)	0.472
– CT	39 (19)	66 (25)	0.105
– TOE	12 (6)	10 (4)	0.310
Repeated examinations during inpatient stay^‡
– Coronary angiography	62 (31)	35 (13)	0.001
– CT	30 (15)	21 (8)	0.022
– TOE	10 (5)	6 (2)	0.126

† Includes examinations already carried out in outside facilities or within previous inpatient stays.

‡ Number reports examinations, that were already carried out in outside facilities and were performed again during the inpatient stay.

CT: Computed tomography; PCI: Percutaneous coronary intervention; TOE: Transesophageal echocardiography.

Table 3. Comparison of length of stays and patients’outcomes between 2014/2015 and 2016/2017.

2014/2015 (n = 203)	2016/2017 (n = 260)	p-value
Time between admission and implantation (days), median (interquartile range)	9 (7–14)	6 (3–10)	0.001^†
Time between implantation and discharge (days), median (interquartile range)	9 (7–15)	7 (6–11)	0.001^†
Total length of stay (days), median (interquartile range)	21 (15–28)	14 (11–21)	0.001^†
30-day mortality, n (%)	8 (4.4)	9 (3.5)	0.409
Postprocedural pacemaker implantation, n (%)	19 (9)	21 (8)	0.626
Major femoral complication^‡, n (%)	11 (5.4)	11 (4.2)	0.566

† Significant

‡ Requiring surgical repair.

Data sharing statement

The authors certify that this manuscript reports original clinical trial data. Individual, de-identified participant data that underlie the results reported in this article (text, tables, figures, and appendices) will be available to anyone who wishes to access the data, for any purpose. Data will be available immediately following publication with no end date. Proposals should be directed to the corresponding author (A Janosi, [email protected]). To gain access, data requestors will need to sign a data access agreement.