TY - JOUR
T1 - Avoiding the Learning Curve for Transcatheter Aortic Valve Replacement
AU - Gurevich, Sergey
AU - John, Ranjit
AU - Kelly, Rosemary F.
AU - Raveendran, Ganesh
AU - Helmer, Gregory
AU - Yannopoulos, Demetris
AU - Biring, Timinder
AU - Oestreich, Brett
AU - Garcia, Santiago
N1 - Publisher Copyright:
© 2017 Sergey Gurevich et al.
PY - 2017
Y1 - 2017
N2 - Objectives. To evaluate whether collaboration between existing and new transcatheter aortic valve replacement (TAVR) programs could help reduce the number of cases needed to achieve optimal efficiency. Background. There is a well-documented learning curve for achieving procedural efficiency and safety in TAVR procedures. Methods. A multidisciplinary collaboration was established between the Minneapolis VA Medical Center (new program) and the University of Minnesota (established program since 2012, n=219) 1 year prior to launching the new program. Results. 269 patients treated with TAVR (50 treated in the first year at the new program). Mean age was 76 (±18) years and STS score was 6.8 (±6). Access included transfemoral (n=35, 70%), transapical (n=8, 16%), transaortic (n=2, 4%), and subclavian (n=5, 10%) types. Procedural efficiency (procedural time 158±59 versus 148±62, p=0.27), device success (96% versus 87%, p=0.08), length of stay (5±3 versus 6±7 days, p=0.10), and safety (in hospital mortality 4% versus 6%, p=0.75) were similar between programs. We found no difference in outcome measures between the first and last 25 patients treated during the first year of the new program. Conclusions. Establishing a partnership with an established program can help mitigate the learning curve associated with these complex procedures.
AB - Objectives. To evaluate whether collaboration between existing and new transcatheter aortic valve replacement (TAVR) programs could help reduce the number of cases needed to achieve optimal efficiency. Background. There is a well-documented learning curve for achieving procedural efficiency and safety in TAVR procedures. Methods. A multidisciplinary collaboration was established between the Minneapolis VA Medical Center (new program) and the University of Minnesota (established program since 2012, n=219) 1 year prior to launching the new program. Results. 269 patients treated with TAVR (50 treated in the first year at the new program). Mean age was 76 (±18) years and STS score was 6.8 (±6). Access included transfemoral (n=35, 70%), transapical (n=8, 16%), transaortic (n=2, 4%), and subclavian (n=5, 10%) types. Procedural efficiency (procedural time 158±59 versus 148±62, p=0.27), device success (96% versus 87%, p=0.08), length of stay (5±3 versus 6±7 days, p=0.10), and safety (in hospital mortality 4% versus 6%, p=0.75) were similar between programs. We found no difference in outcome measures between the first and last 25 patients treated during the first year of the new program. Conclusions. Establishing a partnership with an established program can help mitigate the learning curve associated with these complex procedures.
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U2 - 10.1155/2017/7524925
DO - 10.1155/2017/7524925
M3 - Article
C2 - 28246571
AN - SCOPUS:85012226930
SN - 2090-8016
VL - 2017
JO - Cardiology Research and Practice
JF - Cardiology Research and Practice
M1 - 7524925
ER -