Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey

Enrico Cerrato; Luis Nombela-Franco; Tamim M Nazif; Helene Eltchaninoff; Lars Søndergaard; Henrique B Ribeiro; Marco Barbanti; Fabian Nietlispach; Peter De Jaegere; Pierfrancesco Agostoni; Ramiro Trillo; Pilar Jimenez-Quevedo; Fabrizio D'Ascenzo; Olaf Wendler; Gabriel Maluenda; Mao Chen; Corrado Tamburino; Carlos Macaya; Martin B Leon; Josep Rodes-Cabau

doi:10.1016/j.ijcard.2016.11.104

Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey

Enrico Cerrato, Luis Nombela-Franco, Tamim M Nazif, Helene Eltchaninoff, Lars Søndergaard, Henrique B Ribeiro, Marco Barbanti, Fabian Nietlispach, Peter De Jaegere, Pierfrancesco Agostoni, Ramiro Trillo, Pilar Jimenez-Quevedo, Fabrizio D'Ascenzo, Olaf Wendler, Gabriel Maluenda, Mao Chen, Corrado Tamburino, Carlos Macaya, Martin B Leon, Josep Rodes-Cabau

Department of Clinical Medicine

50 Citations (Scopus)

Abstract

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers.

METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management.

RESULTS: The survey was completed by 250 centers (with a cumulative experience of nearly 70,000 TAVI) from 38 different countries. Heart team meetings and surgical risk scores were routinely performed in most (>95%) centers, but frailty (44%) and quality of life (28%) assessments were less frequently performed. General anesthesia remained the most frequent type of anesthesia (60% of centers), and significant variability was detected in the examinations for residual aortic regurgitation assessment during the procedure and in post-procedural ECG monitoring and temporary pacemaker implementation (from none to ≥72h post-TAVI). Dual antiplatelet therapy duration post-TAVI was highly variable (1, 3, and ≥6months in 14%, 41% and 32% of centers, respectively) and lack of consensus in antithrombotic regimen was observed in patients with atrial fibrillation requiring anticoagulation therapy (anticoagulation alone, anticoagulation+aspirin, anticoagulation+clopidogrel, and triple therapy in 28%, 37%, 26% and 4% of centers, respectively).

CONCLUSIONS: The WRITTEN survey provided extensive data on current TAVI-related practice and identified important differences between centers in key aspects of pre-, intra-, and post-operative management. This highlights the urgent need for further studies and evidence-based data to guide multiple aspects of the TAVI field.

Original language	English
Journal	International Journal of Cardiology
Volume	228
Pages (from-to)	640-647
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2016.11.104
Publication status	Published - 1 Feb 2017

Keywords

Aortic Valve Stenosis/surgery
Fibrinolytic Agents/therapeutic use
Humans
Patient Selection
Postoperative Care
Practice Patterns, Physicians'
Surveys and Questionnaires
Transcatheter Aortic Valve Replacement

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10.1016/j.ijcard.2016.11.104

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Cerrato, E., Nombela-Franco, L., Nazif, T. M., Eltchaninoff, H., Søndergaard, L., Ribeiro, H. B., Barbanti, M., Nietlispach, F., De Jaegere, P., Agostoni, P., Trillo, R., Jimenez-Quevedo, P., D'Ascenzo, F., Wendler, O., Maluenda, G., Chen, M., Tamburino, C., Macaya, C., Leon, M. B., & Rodes-Cabau, J. (2017). Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey. International Journal of Cardiology, 228, 640-647. https://doi.org/10.1016/j.ijcard.2016.11.104

Cerrato, E, Nombela-Franco, L, Nazif, TM, Eltchaninoff, H, Søndergaard, L, Ribeiro, HB, Barbanti, M, Nietlispach, F, De Jaegere, P, Agostoni, P, Trillo, R, Jimenez-Quevedo, P, D'Ascenzo, F, Wendler, O, Maluenda, G, Chen, M, Tamburino, C, Macaya, C, Leon, MB & Rodes-Cabau, J 2017, 'Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey', International Journal of Cardiology, vol. 228, pp. 640-647. https://doi.org/10.1016/j.ijcard.2016.11.104

@article{aab29a37576347088ca98fad30a00385,

title = "Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey",

abstract = "BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers.METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management.RESULTS: The survey was completed by 250 centers (with a cumulative experience of nearly 70,000 TAVI) from 38 different countries. Heart team meetings and surgical risk scores were routinely performed in most (>95%) centers, but frailty (44%) and quality of life (28%) assessments were less frequently performed. General anesthesia remained the most frequent type of anesthesia (60% of centers), and significant variability was detected in the examinations for residual aortic regurgitation assessment during the procedure and in post-procedural ECG monitoring and temporary pacemaker implementation (from none to ≥72h post-TAVI). Dual antiplatelet therapy duration post-TAVI was highly variable (1, 3, and ≥6months in 14%, 41% and 32% of centers, respectively) and lack of consensus in antithrombotic regimen was observed in patients with atrial fibrillation requiring anticoagulation therapy (anticoagulation alone, anticoagulation+aspirin, anticoagulation+clopidogrel, and triple therapy in 28%, 37%, 26% and 4% of centers, respectively).CONCLUSIONS: The WRITTEN survey provided extensive data on current TAVI-related practice and identified important differences between centers in key aspects of pre-, intra-, and post-operative management. This highlights the urgent need for further studies and evidence-based data to guide multiple aspects of the TAVI field.",

keywords = "Aortic Valve Stenosis/surgery, Fibrinolytic Agents/therapeutic use, Humans, Patient Selection, Postoperative Care, Practice Patterns, Physicians', Surveys and Questionnaires, Transcatheter Aortic Valve Replacement",

author = "Enrico Cerrato and Luis Nombela-Franco and Nazif, {Tamim M} and Helene Eltchaninoff and Lars S{\o}ndergaard and Ribeiro, {Henrique B} and Marco Barbanti and Fabian Nietlispach and {De Jaegere}, Peter and Pierfrancesco Agostoni and Ramiro Trillo and Pilar Jimenez-Quevedo and Fabrizio D'Ascenzo and Olaf Wendler and Gabriel Maluenda and Mao Chen and Corrado Tamburino and Carlos Macaya and Leon, {Martin B} and Josep Rodes-Cabau",

year = "2017",

month = feb,

day = "1",

doi = "10.1016/j.ijcard.2016.11.104",

language = "English",

volume = "228",

pages = "640--647",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Evaluation of current practices in transcatheter aortic valve implantation

T2 - The WRITTEN (WoRldwIde TAVI ExperieNce) survey

AU - Cerrato, Enrico

AU - Nombela-Franco, Luis

AU - Nazif, Tamim M

AU - Eltchaninoff, Helene

AU - Søndergaard, Lars

AU - Ribeiro, Henrique B

AU - Barbanti, Marco

AU - Nietlispach, Fabian

AU - De Jaegere, Peter

AU - Agostoni, Pierfrancesco

AU - Trillo, Ramiro

AU - Jimenez-Quevedo, Pilar

AU - D'Ascenzo, Fabrizio

AU - Wendler, Olaf

AU - Maluenda, Gabriel

AU - Chen, Mao

AU - Tamburino, Corrado

AU - Macaya, Carlos

AU - Leon, Martin B

AU - Rodes-Cabau, Josep

PY - 2017/2/1

Y1 - 2017/2/1

N2 - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers.METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management.RESULTS: The survey was completed by 250 centers (with a cumulative experience of nearly 70,000 TAVI) from 38 different countries. Heart team meetings and surgical risk scores were routinely performed in most (>95%) centers, but frailty (44%) and quality of life (28%) assessments were less frequently performed. General anesthesia remained the most frequent type of anesthesia (60% of centers), and significant variability was detected in the examinations for residual aortic regurgitation assessment during the procedure and in post-procedural ECG monitoring and temporary pacemaker implementation (from none to ≥72h post-TAVI). Dual antiplatelet therapy duration post-TAVI was highly variable (1, 3, and ≥6months in 14%, 41% and 32% of centers, respectively) and lack of consensus in antithrombotic regimen was observed in patients with atrial fibrillation requiring anticoagulation therapy (anticoagulation alone, anticoagulation+aspirin, anticoagulation+clopidogrel, and triple therapy in 28%, 37%, 26% and 4% of centers, respectively).CONCLUSIONS: The WRITTEN survey provided extensive data on current TAVI-related practice and identified important differences between centers in key aspects of pre-, intra-, and post-operative management. This highlights the urgent need for further studies and evidence-based data to guide multiple aspects of the TAVI field.

AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers.METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management.RESULTS: The survey was completed by 250 centers (with a cumulative experience of nearly 70,000 TAVI) from 38 different countries. Heart team meetings and surgical risk scores were routinely performed in most (>95%) centers, but frailty (44%) and quality of life (28%) assessments were less frequently performed. General anesthesia remained the most frequent type of anesthesia (60% of centers), and significant variability was detected in the examinations for residual aortic regurgitation assessment during the procedure and in post-procedural ECG monitoring and temporary pacemaker implementation (from none to ≥72h post-TAVI). Dual antiplatelet therapy duration post-TAVI was highly variable (1, 3, and ≥6months in 14%, 41% and 32% of centers, respectively) and lack of consensus in antithrombotic regimen was observed in patients with atrial fibrillation requiring anticoagulation therapy (anticoagulation alone, anticoagulation+aspirin, anticoagulation+clopidogrel, and triple therapy in 28%, 37%, 26% and 4% of centers, respectively).CONCLUSIONS: The WRITTEN survey provided extensive data on current TAVI-related practice and identified important differences between centers in key aspects of pre-, intra-, and post-operative management. This highlights the urgent need for further studies and evidence-based data to guide multiple aspects of the TAVI field.

KW - Aortic Valve Stenosis/surgery

KW - Fibrinolytic Agents/therapeutic use

KW - Humans

KW - Patient Selection

KW - Postoperative Care

KW - Practice Patterns, Physicians'

KW - Surveys and Questionnaires

KW - Transcatheter Aortic Valve Replacement

U2 - 10.1016/j.ijcard.2016.11.104

DO - 10.1016/j.ijcard.2016.11.104

M3 - Journal article

C2 - 27883975

SN - 0167-5273

VL - 228

SP - 640

EP - 647

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey

Abstract

Keywords

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