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Frank D, Durand E, Lauck S, Muir DF, Spence M, Vasa-Nicotera M, Wood D, Saia F, Urbano-Carrillo CA, Bouchayer D, Iliescu VA, Saint Etienne C, Leclercq F, Auffret V, Asmarats L, Di Mario C, Veugeois A, Maly J, Schober A, Nombela-Franco L, Werner N, Gómez-Hospital JA, Mascherbauer J, Musumeci G, Meneveau N, Meurice T, Mahfoud F, De Marco F, Seidler T, Leuschner F, Joly P, Collet JP, Vogt F, Di Lorenzo E, Kuhn E, Disdier VP, Hachaturyan V, Lüske CM, Rakova R, Wesselink W, Kurucova J, Bramlage P, McCalmont G. A streamlined pathway for transcatheter aortic valve implantation: the BENCHMARK study. Eur Heart J 2024; 45:1904-1916. [PMID: 38554125 PMCID: PMC11143387 DOI: 10.1093/eurheartj/ehae147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/23/2024] [Accepted: 02/27/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND AND AIMS There is significant potential to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI). The purpose of this study was to evaluate the effect of implementing BENCHMARK best practices on the efficiency and safety of TAVI in 28 sites in 7 European countries. METHODS This was a study of patients with severe symptomatic aortic stenosis (AS) undergoing TAVI with balloon-expandable valves before and after implementation of BENCHMARK best practices. Principal objectives were to reduce hospital length of stay (LoS) and duration of intensive care stay. Secondary objective was to document patient safety. RESULTS Between January 2020 and March 2023, 897 patients were documented prior to and 1491 patients after the implementation of BENCHMARK practices. Patient characteristics were consistent with a known older TAVI population and only minor differences. Mean LoS was reduced from 7.7 ± 7.0 to 5.8 ± 5.6 days (median 6 vs. 4 days; P < .001). Duration of intensive care was reduced from 1.8 to 1.3 days (median 1.1 vs. 0.9 days; P < .001). Adoption of peri-procedure best practices led to increased use of local anaesthesia (96.1% vs. 84.3%; P < .001) and decreased procedure (median 47 vs. 60 min; P < .001) and intervention times (85 vs. 95 min; P < .001). Thirty-day patient safety did not appear to be compromised with no differences in all-cause mortality (0.6% in both groups combined), stroke/transient ischaemic attack (1.4%), life-threatening bleeding (1.3%), stage 2/3 acute kidney injury (0.7%), and valve-related readmission (1.2%). CONCLUSIONS Broad implementation of BENCHMARK practices contributes to improving efficiency of TAVI pathway reducing LoS and costs without compromising patient safety.
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Affiliation(s)
- Derk Frank
- Department of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), University Clinical Centre Schleswig-Holstein (UKSH), Arnold-Heller Strasse 3, Haus K3, Kiel 24105, Germany
- Department of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), German Centre for Cardiovascular Research, partner site Hamburg/Kiel/Lübeck, Arnold-Heller Strasse 3, Haus K3, Kiel 24105, Germany
| | - Eric Durand
- Department of Cardiology, Univ Rouen Normandie, Inserm U1096, CHU Rouen, Rouen, France
| | - Sandra Lauck
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Douglas F Muir
- Cardiology Department, James Cook University Hospital, Middlesbrough, UK
| | - Mark Spence
- Cardiology Department, Mater Private Network, Dublin, Ireland
| | | | - David Wood
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Francesco Saia
- Department of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | | | - Damien Bouchayer
- Department of Cardiology, The Clinique de l'Infirmerie Protestante, Lyon, France
| | - Vlad Anton Iliescu
- Department of Cardiology, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Christophe Saint Etienne
- Department of Cardiology, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Hôpital Trousseau, Tours, France
| | - Florence Leclercq
- Cardiology Department, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Vincent Auffret
- Université de Rennes 1, CHU Rennes Service de Cardiologie, Inserm LTSI U1099, Rennes, France
| | - Lluis Asmarats
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Carlo Di Mario
- Structural Interventional Cardiology Division, Department of Clinical & Experimental Medicine, Careggi University Hospital, Florence, Italy
| | - Aurelie Veugeois
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Jiri Maly
- Cardiac Center, IKEM Prague, Prague, Czech Republic
| | - Andreas Schober
- Department of Cardiology, Hospital Floridsdorf, Vienna, Austria
- Karl Landsteiner Institute for Cardiovascular and Critical Care Research Vienna, Vienna, Austria
| | - Luis Nombela-Franco
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nikos Werner
- Medical Department III, Heart Center Trier, Krankenhaus der Barmherzigen Brüder, Trier, Germany
| | - Joan Antoni Gómez-Hospital
- Heart Diseases Institute, Bellvitge University Hospital—IDIBELL, University of Barcelona, Barcelona, Spain
| | - Julia Mascherbauer
- Department of Internal Medicine 3/Cardiology, University Hospital St. Pölten, St. Pölten, Austria
| | - Giuseppe Musumeci
- Struttura Complessa of Cardiology, Ospedale Mauriziano, Torino, Italy
| | - Nicolas Meneveau
- Cardiology, Besancon Regional University Hospital Center, Besancon, France
| | | | - Felix Mahfoud
- Internal Medicine III, Cardiology, Angiology and Internal Intensive Care Medicine, University Hospital of Saarland, Homburg, Germany
| | | | - Tim Seidler
- Department of Cardiology and Pulmonology, Georg-August-University, Göttingen, Germany
- Department of Cardiology, University Medicine Göttingen, Heart Center, Göttingen, Germany
- Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany
| | - Florian Leuschner
- Department of Medicine III, University of Heidelberg, German Centre for Cardiovascular Research (DZHK), Heilderberg, Germany
| | - Patrick Joly
- Department of Interventional Cardiology, Hôpital Saint Joseph, Marseille, France
| | | | - Ferdinand Vogt
- Department for Cardiovascular Surgery, Artemed Klinikum München, München, Germany
| | - Emilio Di Lorenzo
- Division of Cardiology, Department of Cardiovascular Surgery, L’Ospedale S.Giuseppe Moscati di Avellino, Avellino, Italy
| | - Elmar Kuhn
- Department of Cardiothoracic Surgery, Heart Center, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | | | | | - Claudia M Lüske
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | | | | | | | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Gemma McCalmont
- Cardiology Department, James Cook University Hospital, Middlesbrough, UK
- Edwards Lifesciences, Nyon, Switzerland
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Borregaard B, Lauck SB. Improving the heart valve disease journey of care: a new action plan for better partnerships with patients, clinicians, and policymakers. Eur J Cardiovasc Nurs 2023; 22:e118-e119. [PMID: 37157173 DOI: 10.1093/eurjcn/zvad042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Britt Borregaard
- Department of Cardiology, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense C, Denmark
- Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense C, Denmark
- Faculty of Health Science, University of Southern Denmark, Winsløwparken 19, 5000 Odense C, Denmark
| | - Sandra B Lauck
- Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada
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3
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Zamorano JL, Appleby C, Benamer H, Frankenstein L, Musumeci G, Nombela-Franco L. Improving access to transcatheter aortic valve implantation across Europe by restructuring cardiovascular services: An expert council consensus statement. Catheter Cardiovasc Interv 2023; 102:547-557. [PMID: 37431253 DOI: 10.1002/ccd.30760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/01/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) is recommended for a growing range of patients with severe aortic stenosis in the European Society of Cardiology and European Association for Cardio-Thoracic Surgery (ESC/EACTS) 2021 Guidelines update. However, guideline implementation programs are needed to ensure the application of clinical recommendations which will favorably influence disease outcomes. An Expert Council was convened to identify whether cardiology services across Europe are set up to address the growing needs of patients with severe aortic stenosis for increased access to TAVI by identifying the key challenges faced in growing TAVI programs and mapping associated solutions. Wide variation exists across Europe in terms of TAVI availability and capacity to deliver the increased demand for TAVI in different countries. The recommendations of this Expert Council focus on the short-to-medium-term aspects where the most immediate, actionable impact can be achieved. The focus on improving procedural efficiency and optimizing the patient pathway via clinical practice and patient management demonstrates how to mitigate the current major issues of shortfall in catheterization laboratory, workforce, and bed capacity. Procedural efficiencies may be achieved through steps including streamlined patient assessment, the benchmarking of standards for minimalist procedures, standardized approaches around patient monitoring and conduction issues, and the implementation of nurse specialists and dedicated TAVI coordinators to manage organization, logistics, and early mobilization. Increased collaboration with wider stakeholders within institutions will support successful TAVI uptake and improve patient and economic outcomes. Further, increased education, collaboration, and partnership between cardiology centers will facilitate sharing of expertise and best clinical practice.
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Affiliation(s)
- José Luis Zamorano
- Department of Cardiology, University Hospital Ramon y Cajal, Madrid, Spain
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Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement for Long-Term Mortality Due to Stroke and Myocardial Infarction: A Meta-Analysis during the COVID-19 Pandemic. Medicina (B Aires) 2022; 59:medicina59010012. [PMID: 36676636 PMCID: PMC9864266 DOI: 10.3390/medicina59010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background and objectives: One of the leading causes of mortality and morbidity in people over the age of 50 is stroke. The acceptance of transcatheter aortic valve replacement (TAVR) as a treatment option for severe symptomatic aortic stenosis (AS) has increased as a result of numerous randomized clinical trials comparing surgical aortic valve replacement (SAVR) and TAVR in high- and intermediate-risk patients, showing comparable clinical outcomes and valve hemodynamics. Materials and Methods: An electronic search of Medline, Google Scholar and Cochrane Central was carried out from their inception to 28 September 2022 without any language restrictions. Results: Our meta-analysis demonstrated that, as compared with SAVR, TAVR was not linked with a lower stroke ratio or stroke mortality. It is clear from this that the SAVR intervention techniques applied in the six studies were successful in reducing cardiogenic consequences over time. Conclusions: A significantly decreased rate of mortality from cardiogenic causes was associated with SAVR. Additionally, when TAVR and SAVR were compared for stroke mortality, the results were nonsignificant with a p value of 0.57, indicating that none of these procedures could decrease stroke-related mortality.
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5
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Martins MS, Lourenção DCDA, Pimentel RRDS, de Oliveira JM, Manganoti LTDCN, Modesto RC, Silva MSDS, Dos Santos MJ. Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review. BMJ Open 2022; 12:e060182. [PMID: 36123068 PMCID: PMC9485646 DOI: 10.1136/bmjopen-2021-060182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To map the recommendations for hospitalised patient safety in the context of the COVID-19 pandemic. DESIGN Scoping review using the method recommended by the Joanna Briggs Institute. DATA SOURCES Databases: Medline, SCOPUS, EMBASE, ScienceDirect, LILACS, CINAHL and IBECS; grey literature platform: Google Scholar; and 11 official websites of leading healthcare institutions were searched on 27 April 2021 and updated on 11 April 2022. ELIGIBILITY CRITERIA We included documents that present recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic, published in any language, from 2020 onwards. DATA EXTRACTION AND SYNTHESIS Data extraction was performed in pairs with consensus rounds. A descriptive analysis was carried out to present the main characteristics of the articles. Qualitative data from the extraction of recommendations were analysed through content analysis. RESULTS One hundred and twenty-five documents were included. Most papers were identified as expert consensus (n=56, 44.8%). Forty-six recommendations were identified for the safety of hospitalised patients: 17 relating to the reorganisation of health services related to the flow of patients, the management of human and material resources and the reorganisation of the hospital environment; 11 on the approach to the airways and the prevention of the spread of aerosols; 11 related to sanitary and hygiene issues; 4 about proper use of personal protective equipment and 3 for effective communication. CONCLUSIONS The recommendations mapped in this scoping review present the best practices produced so far and serve as a basis for planning and implementing good practices to ensure safe hospital care, during and after COVID-19. The engagement of everyone involved in the care of hospitalised patients is essential to consolidate the mapped recommendations and provide dignified, safe and quality care.
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Affiliation(s)
| | | | | | - Janine Melo de Oliveira
- Escola de Enfermagem, Universidade Federal de Alagoas, Maceio, Brazil
- Curso de Enfermagem, Universidade Estadual de Ciências da Saúde de Alagoas, Maceio, Brazil
| | | | | | | | - Marcelo José Dos Santos
- Career Guidance Department, Universidade de São Paulo Escola de Enfermagem, Sao Paulo, Brazil
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6
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Rooijakkers MJP, Li WWL, Stens NA, Vis MM, Tonino PAL, Timmers L, Van Mieghem NM, den Heijer P, Kats S, Stella PR, Roolvink V, van der Werf HW, Stoel MG, Schotborgh CE, Amoroso G, Porta F, van der Kley F, van Wely MH, Gehlmann H, van Garsse LAFM, Geuzebroek GSC, Verkroost MWA, Mourisse JM, Medendorp NM, van Royen N. Transcatheter aortic valve implantation amid the COVID-19 pandemic: a nationwide analysis of the first COVID-19 wave in the Netherlands. Neth Heart J 2022; 30:503-509. [PMID: 35648264 PMCID: PMC9158307 DOI: 10.1007/s12471-022-01704-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 12/19/2022] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has put tremendous pressure on healthcare systems. Most transcatheter aortic valve implantation (TAVI) centres have adopted different triage systems and procedural strategies to serve highest-risk patients first and to minimise the burden on hospital logistics and personnel. We therefore assessed the impact of the COVID-19 pandemic on patient selection, type of anaesthesia and outcomes after TAVI. Methods We used data from the Netherlands Heart Registration to examine all patients who underwent TAVI between March 2020 and July 2020 (COVID cohort), and between March 2019 and July 2019 (pre-COVID cohort). We compared patient characteristics, procedural characteristics and clinical outcomes. Results We examined 2131 patients who underwent TAVI (1020 patients in COVID cohort, 1111 patients in pre-COVID cohort). EuroSCORE II was comparable between cohorts (COVID 4.5 ± 4.0 vs pre-COVID 4.6 ± 4.2, p = 0.356). The number of TAVI procedures under general anaesthesia was lower in the COVID cohort (35.2% vs 46.5%, p < 0.001). Incidences of stroke (COVID 2.7% vs pre-COVID 1.7%, p = 0.134), major vascular complications (2.3% vs 3.4%, p = 0.170) and permanent pacemaker implantation (10.0% vs 9.4%, p = 0.634) did not differ between cohorts. Thirty-day and 150-day mortality were comparable (2.8% vs 2.2%, p = 0.359 and 5.2% vs 5.2%, p = 0.993, respectively). Conclusions During the COVID-19 pandemic, patient characteristics and outcomes after TAVI were not different than before the pandemic. This highlights the fact that TAVI procedures can be safely performed during the COVID-19 pandemic, without an increased risk of complications or mortality. Supplementary Information The online version of this article (10.1007/s12471-022-01704-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M J P Rooijakkers
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W W L Li
- Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - N A Stens
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M M Vis
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - P A L Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - L Timmers
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - N M Van Mieghem
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - P den Heijer
- Department of Cardiology, Amphia Hospital, Breda, The Netherlands
| | - S Kats
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - P R Stella
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - V Roolvink
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - H W van der Werf
- Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - M G Stoel
- Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - C E Schotborgh
- Department of Cardiology, Haga Hospital, The Hague, The Netherlands
| | - G Amoroso
- Department of Cardiology, OLVG Hospital, Amsterdam, The Netherlands
| | - F Porta
- Department of Cardiothoracic Surgery, Leeuwarden Medical Centre, Leeuwarden, The Netherlands
| | - F van der Kley
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - M H van Wely
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - H Gehlmann
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - L A F M van Garsse
- Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - G S C Geuzebroek
- Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M W A Verkroost
- Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J M Mourisse
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - N M Medendorp
- Netherlands Heart Registration, Utrecht, The Netherlands
| | - N van Royen
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
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Lauck SB, McCalmont G, Smith A, Højberg Kirk B, de Ronde-Tillmans M, Wundram S, Adhami N. Setting a Benchmark for Quality of Care. Crit Care Nurs Clin North Am 2022; 34:215-231. [DOI: 10.1016/j.cnc.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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8
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McCalmont G, Durand E, Lauck S, Muir DF, Spence MS, Vasa-Nicotera M, Wood D, Saia F, Chatel N, Lüske CM, Kurucova J, Bramlage P, Frank D. Setting a benchmark for resource utilization and quality of care in patients undergoing transcatheter aortic valve implantation in Europe-Rationale and design of the international BENCHMARK registry. Clin Cardiol 2021; 44:1344-1353. [PMID: 34499383 PMCID: PMC8495089 DOI: 10.1002/clc.23711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022] Open
Abstract
Background The use of transcatheter aortic valve implantation (TAVI) for treating aortic stenosis (AS) has increased exponentially in recent years. Despite the availability of clinical practice guidelines for the management of valvular heart disease, disparities in quality of care (QoC) for TAVI patients remain widespread across Europe. Tailored QoC measures will help to reduce resource utilization and improve patient outcomes without compromising patient safety. Using a clear set of QoC measures, the BENCHMARK registry aims to document the progress that can be achieved if such tailored QoC measures are implemented. Methods The BENCHMARK registry (BENCHMARK) is a non‐interventional, multicenter registry in patients with severe symptomatic AS undergoing TAVI with a 1‐ and 12‐months follow‐up. BENCHMARK will be conducted at 30 centers across Europe and will enroll a total of 2400 consecutive TAVI patients. Patients suffering from severe symptomatic AS who undergo TAVI with a balloon‐expandable transcatheter aortic valve will be included. The registry will comprise four phases: (1) a retrospective baseline evaluation phase; (2) an education phase; (3) an implementation phase; and (4) a prospective effect documentation phase (prospective phase). The registry's primary objectives are to reduce the length of hospital stay and accelerate the post‐procedural patient recovery pathway, but without compromising safety. The study started in April 2021 and has an estimated completion date of May 2023. Discussion BENCHMARK will establish QoC measures to reduce resource utilization, intensive care unit bed occupancy, and overall length of hospitalization with uncompromised patient safety post‐TAVI (ClinicalTrials.gov Identifier: NCT04579445). HighlightsThe BENCHMARK registry is a non‐interventional, multicenter international registry. A total of 2400 patients with severe AS will be enrolled at 30 European centers. The registry is designed to be partly retrospective and partly prospective. The BENCHMARK registry will help to improve TAVI QoC standards across Europe.
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Affiliation(s)
- Gemma McCalmont
- Cardiology Department, James Cook University Hospital, Middlesbrough, UK
| | - Eric Durand
- Department of Cardiology, FHU CARNAVAL, Normandie University, UNIROUEN, Rouen, France
| | - Sandra Lauck
- Center for Heart Valve Innovation, St Paul's Hospital, University of Vancouver, Vancouver, British Columbia, Canada
| | - Douglas F Muir
- Cardiology Department, James Cook University Hospital, Middlesbrough, UK
| | - Mark S Spence
- Cardiology Department, Royal Victoria Hospital, Belfast, UK
| | | | - David Wood
- Center for Heart Valve Innovation, St Paul's Hospital, University of Vancouver, Vancouver, British Columbia, Canada
| | - Francesco Saia
- Department of Cardiology, University of Bologna, Bologna, Italy
| | | | - Claudia M Lüske
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | | | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Derk Frank
- Department of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), University Clinical Center Schleswig-Holstein (UKSH), Kiel, Germany.,German Center for Cardiovascular Research, partner site Hamburg/Kiel/Lübeck, Kiel, Germany
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9
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Moons P, Goossens E, Thompson DR. Rapid reviews: the pros and cons of an accelerated review process. Eur J Cardiovasc Nurs 2021; 20:515-519. [PMID: 34007994 DOI: 10.1093/eurjcn/zvab041] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 11/12/2022]
Abstract
Although systematic reviews are the method of choice to synthesize scientific evidence, they can take years to complete and publish. Clinicians, managers, and policy-makers often need input from scientific evidence in a more timely and resource-efficient manner. For this purpose, rapid reviews are conducted. Rapid reviews are performed using an accelerated process. However, they should not be less systematic than standard systematic reviews, and the introduction of bias must be avoided. In this article, we describe what rapid reviews are, present their characteristics, give some examples, highlight potential pitfalls, and draw attention to the importance of evidence summaries in order to facilitate adoption in clinical decision-making.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Box 7001, B-3000 Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Eva Goossens
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Box 7001, B-3000 Leuven, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium.,Centre for Research and Innovation, Division of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Public Health, Monash University, Melbourne, Australia
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10
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Martin GP, Curzen N, Goodwin AT, Nolan J, Balacumaraswami L, Ludman PF, Kontopantelis E, Wu J, Gale CP, de Belder MA, Mamas MA. Indirect Impact of the COVID-19 Pandemic on Activity and Outcomes of Transcatheter and Surgical Treatment of Aortic Stenosis in England. Circ Cardiovasc Interv 2021; 14:e010413. [PMID: 34003671 PMCID: PMC8126473 DOI: 10.1161/circinterventions.120.010413] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Supplemental Digital Content is available in the text. Aortic stenosis requires timely treatment with either surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). This study aimed to investigate the indirect impact of coronavirus disease 2019 (COVID-19) on national SAVR and TAVR activity and outcomes.
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Affiliation(s)
- Glen P Martin
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, United Kingdom (G.P.M., E.K.)
| | - Nick Curzen
- Wessex Cardiothoracic Unit, Southampton University Hospital Southampton and Faculty of Medicine, University of Southampton, United Kingdom (N.C.)
| | - Andrew T Goodwin
- South Tees Hospital NHS Foundation Trust, Middlesbrough, United Kingdom (A.T.G.).,National Institute for Cardiovascular Outcomes Research, Barts Health NHS Trust, London, United Kingdom (A.T.G., M.A.d.B.)
| | - James Nolan
- Royal Stoke Hospital, Stoke on Trent and Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, United Kingdom (J.N., L.B., M.A.M.)
| | - Lognathen Balacumaraswami
- Royal Stoke Hospital, Stoke on Trent and Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, United Kingdom (J.N., L.B., M.A.M.)
| | - Peter F Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (P.F.L.)
| | - Evangelos Kontopantelis
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, United Kingdom (G.P.M., E.K.)
| | - Jianhua Wu
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, United Kingdom (J.W., C.P.G.)
| | - Chris P Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, United Kingdom (J.W., C.P.G.)
| | - Mark A de Belder
- National Institute for Cardiovascular Outcomes Research, Barts Health NHS Trust, London, United Kingdom (A.T.G., M.A.d.B.).,Thomas Jefferson University, Philadelphia, PA (M.A.M.)
| | - Mamas A Mamas
- Royal Stoke Hospital, Stoke on Trent and Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, United Kingdom (J.N., L.B., M.A.M.)
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11
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Affiliation(s)
- Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.,Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia.,Centre for Heart Rhythm Disorders, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia
| | - Tiny Jaarsma
- Institute of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden.,Julius Centrum, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CX Utrecht, The Netherlands
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12
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Guarracino F, Shernan SK, Tahan ME, Bertini P, Stone ME, Kachulis B, Paternoster G, Mukherjee C, Wouters P, Rex S. EACTA/SCA Recommendations for the Cardiac Anesthesia Management of Patients With Suspected or Confirmed COVID-19 Infection: An Expert Consensus From the European Association of Cardiothoracic Anesthesiology and Society of Cardiovascular Anesthesiologists With Endorsement From the Chinese Society of Cardiothoracic and Vascular Anesthesiology. J Cardiothorac Vasc Anesth 2021; 35:1953-1963. [PMID: 33766471 PMCID: PMC7889009 DOI: 10.1053/j.jvca.2021.02.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 12/20/2022]
Abstract
The European Association of Cardiothoracic Anaesthesiology (EACTA) and the Society of Cardiovascular Anesthesiologists (SCA) aimed to create joint recommendations for the perioperative management of patients with suspected or proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection undergoing cardiac surgery or invasive cardiac procedures. To produce appropriate recommendations, the authors combined the evidence from the literature review, reevaluating the clinical experience of routine cardiac surgery in similar cases during the Middle East Respiratory Syndrome (MERS-CoV) outbreak and the current pandemic with suspected coronavirus disease 2019 (COVID-19) patients, and the expert opinions through broad discussions within the EACTA and SCA. The authors took into consideration the balance between established procedures and the feasibility during the present outbreak. The authors present an agreement between the European and US practices in managing patients during the COVID-19 pandemic. The recommendations take into consideration a broad spectrum of issues, with a focus on preoperative testing, safety concerns, overall approaches to general and specific aspects of preparation for anesthesia, airway management, transesophageal echocardiography, perioperative ventilation, coagulation, hemodynamic control, and postoperative care. As the COVID-19 pandemic is spreading, it will continue to present a challenge for the worldwide anesthesiology community. To allow these recommendations to be updated as long as possible, the authors provided weblinks to international public and academic sources providing timely updated data. This document should be the basis of future task forces to develop a more comprehensive consensus considering new evidence uncovered during the COVID-19 pandemic.
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Affiliation(s)
- Fabio Guarracino
- Cardiothoracic and Vascular Anesthesia and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
| | - Stanton K Shernan
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Mohamed El Tahan
- Department of Anaesthesia, Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Pietro Bertini
- Cardiothoracic and Vascular Anesthesia and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marc E Stone
- Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, Mount Sinai Medical Center, New York, NY
| | - Bessie Kachulis
- New York-Presbyterian Hospital/Weill Cornell Medical College, Cornell University, New York, NY
| | - Gianluca Paternoster
- Division of Cardiac Resuscitation, Cardiovascular Anesthesia and Intensive Care, San Carlo Hospital, Potenza, Italy
| | - Chirojit Mukherjee
- Department of Anesthesia and Intensive Care, Helios Clinic for Cardiac Surgery, Karlsruhe, Germany
| | - Patrick Wouters
- Anesthesia and Perioperative Medicine, Ghent University, Ghent, Belgium
| | - Steffen Rex
- Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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13
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Gonzálvez-García A, Jiménez-Valero S, Jurado-Román A, Galeote G, Moreno R. Transcatheter Aortic Valve Implantation During COVID-19 Pandemic: The Device Also Matters. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 26:66-67. [PMID: 32921594 PMCID: PMC7834872 DOI: 10.1016/j.carrev.2020.08.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/27/2020] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Alfonso Jurado-Román
- Unit of Interventional Cardiology, Hospital La Paz, IdiPAZ, CIBER-CV, Madrid, Spain
| | - Guillermo Galeote
- Unit of Interventional Cardiology, Hospital La Paz, IdiPAZ, CIBER-CV, Madrid, Spain
| | - Raúl Moreno
- Unit of Interventional Cardiology, Hospital La Paz, IdiPAZ, CIBER-CV, Madrid, Spain.
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