New data from the Benchmark Registry, a study of a streamlined transcatheter aortic valve implantation (TAVI) pathway in European centres, has demonstrated the safety and effectiveness of the pathway for patients receiving the therapy with balloon-expandable valves.
Data from the trial, which was sponsored by Edwards Lifesciences were presented in a late-breaking clinical data session at EuroPCR 2023 (16–19 May, Paris, France).
The study observed 2,405 patients who underwent TAVI with a balloon-expandable valve at 28 sites in seven European countries to determine if implementing a set of tailored Benchmark practices could improve hospital length of stay (LOS), intensive care unit (ICU) bed occupancy, and patient and staff satisfaction while preserving patient safety.
Patients undergoing TAVI experienced a 25% reduction in ICU stay, a 33% reduction in the median hospital LoS while maintaining 30-day clinical outcomes similar to patients treated before the implementation of the Benchmark pathway. Researchers concluded that a wider implementation of Benchmark best practices will make the TAVR pathway more efficient without compromising patient safety.
Beyond a marked decrease in ICU stay and hospital LoS with no loss of patient safety at 30 days, the study results also reflected high patient satisfaction with all elements of the Benchmark practices, scoring above 90% in post-procedure patient satisfaction surveys.
“The results of this study validate the Edwards Benchmark program as an important tool in reducing the variation in clinical pathways for patients undergoing TAVI [TAVR] across Europe,” said Derk Frank (University Hospital Schleswig-Holstein, Kiel, Germany). “Our results indicate significant improvements in efficiency without compromising patient safety.”
The Edwards Benchmark programme standardises a minimalist approach to TAVI with a focus on conscious sedation, recovery outside the ICU, and a goal of next-day discharge that unlocks the inherent benefits of TAVI’s less invasive nature while preserving patient outcomes. An economic analysis by the PARTNER 3 trial investigators identified TAVI as an “economically dominant” strategy to surgical aortic valve replacement (SAVR) among low risk patients and recognized the potential for greater efficiencies with the continued evolution of minimalist TAVI procedures.
Further research found that a minimalist TAVI pathway (compared to standard TAVI from the SAPIEN 3 Intermediate Risk Registry) was associated with potential cost savings of US$11,000 per case during the index hospitalisation.