Transcatheter aortic valve implantation complexity score
Background Increasing demand for transcatheter aortic valve implantation (TAVI) places greater emphasis on the efficiency of pathways and services. A significant limitation to increasing TAVI capacity is the availability of cardiac catheterisation laboratory time. We have developed a novel complexit...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e002804.full |
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| author | Christopher Malkin Daniel J Blackman Noman Ali Amr Abdelrahman Michael Cunnington Paul Bamford Sacchin Arockiam Suleman Aktaa Rowan Hall |
| author_facet | Christopher Malkin Daniel J Blackman Noman Ali Amr Abdelrahman Michael Cunnington Paul Bamford Sacchin Arockiam Suleman Aktaa Rowan Hall |
| author_sort | Christopher Malkin |
| collection | DOAJ |
| description | Background Increasing demand for transcatheter aortic valve implantation (TAVI) places greater emphasis on the efficiency of pathways and services. A significant limitation to increasing TAVI capacity is the availability of cardiac catheterisation laboratory time. We have developed a novel complexity scoring system (TAVI ComplEXity; TEX score) which can aid in planning lists with appropriate case selection. To validate the TEX score, we have undertaken a retrospective analysis of TAVI cases. The hypothesis is that increasing TEX score correlates with increased procedural duration and reduced valve academic research consortium (VARC) 3 technical and device success.Methods The TEX score assigns patients to a complexity level of 1 (low), 2 (intermediate) or 3 (high) based on the presence of specific clinical and anatomical variables. For validation purposes, comparisons were made between patients in the three complexity levels with respect to procedural duration as well as VARC-3 technical success, device success and early safety.Results The validation study included 1034 consecutive patients who underwent TAVI between June 2021 and October 2023. Of these, 582 (56.3%) were classified as level 1 complexity, 377 (36.5%) level 2 and 75 (7.3%) level 3. Significant differences were observed between the three groups with respect to procedural duration (73.7 min vs 85.6 min vs 136 min; p<0.001), VARC-3 technical success (97.9% vs 96.6% vs 92%; p<0.05) and VARC-3 device success (96.2% vs 92.3% vs 86.6%; p<0.001).Conclusion The TEX score is a simple tool which allows stratification of patients into three levels of complexity. Increasing complexity levels correlate with increasing procedural duration and reduced VARC-3 technical and device success. This is potentially useful for scheduling patients onto appropriate lists. |
| format | Article |
| id | doaj-art-b78d49edbab44e599bb6d2a43ea2ca77 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-b78d49edbab44e599bb6d2a43ea2ca772025-01-09T21:40:09ZengBMJ Publishing GroupOpen Heart2053-36242025-01-0112110.1136/openhrt-2024-002804Transcatheter aortic valve implantation complexity scoreChristopher Malkin0Daniel J Blackman1Noman Ali2Amr Abdelrahman3Michael Cunnington4Paul Bamford5Sacchin Arockiam6Suleman Aktaa7Rowan Hall8Department of Cardiology, Leeds General Infirmary, Leeds, UK7 Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Cardiology, Leeds General Infirmary, Leeds, UKBlackpool Victoria HospitalDepartment of Epidemiology and Public Health, School of Health Sciences, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HHDepartment of Cardiology, Central Coast Local Health District, Gosford, New South Wales, AustraliaDepartment of Cardiology, University Hospital Limerick, Limerick, IrelandDepartment of Cardiology, Leeds General Infirmary, Leeds, UKDepartment of Cardiology, Leeds General Infirmary, Leeds, UKBackground Increasing demand for transcatheter aortic valve implantation (TAVI) places greater emphasis on the efficiency of pathways and services. A significant limitation to increasing TAVI capacity is the availability of cardiac catheterisation laboratory time. We have developed a novel complexity scoring system (TAVI ComplEXity; TEX score) which can aid in planning lists with appropriate case selection. To validate the TEX score, we have undertaken a retrospective analysis of TAVI cases. The hypothesis is that increasing TEX score correlates with increased procedural duration and reduced valve academic research consortium (VARC) 3 technical and device success.Methods The TEX score assigns patients to a complexity level of 1 (low), 2 (intermediate) or 3 (high) based on the presence of specific clinical and anatomical variables. For validation purposes, comparisons were made between patients in the three complexity levels with respect to procedural duration as well as VARC-3 technical success, device success and early safety.Results The validation study included 1034 consecutive patients who underwent TAVI between June 2021 and October 2023. Of these, 582 (56.3%) were classified as level 1 complexity, 377 (36.5%) level 2 and 75 (7.3%) level 3. Significant differences were observed between the three groups with respect to procedural duration (73.7 min vs 85.6 min vs 136 min; p<0.001), VARC-3 technical success (97.9% vs 96.6% vs 92%; p<0.05) and VARC-3 device success (96.2% vs 92.3% vs 86.6%; p<0.001).Conclusion The TEX score is a simple tool which allows stratification of patients into three levels of complexity. Increasing complexity levels correlate with increasing procedural duration and reduced VARC-3 technical and device success. This is potentially useful for scheduling patients onto appropriate lists.https://openheart.bmj.com/content/12/1/e002804.full |
| spellingShingle | Christopher Malkin Daniel J Blackman Noman Ali Amr Abdelrahman Michael Cunnington Paul Bamford Sacchin Arockiam Suleman Aktaa Rowan Hall Transcatheter aortic valve implantation complexity score Open Heart |
| title | Transcatheter aortic valve implantation complexity score |
| title_full | Transcatheter aortic valve implantation complexity score |
| title_fullStr | Transcatheter aortic valve implantation complexity score |
| title_full_unstemmed | Transcatheter aortic valve implantation complexity score |
| title_short | Transcatheter aortic valve implantation complexity score |
| title_sort | transcatheter aortic valve implantation complexity score |
| url | https://openheart.bmj.com/content/12/1/e002804.full |
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