Transcatheter aortic valve replacement program development: Recommendations for best practice

Abstract

TAVR represents a paradigm shift in the management of structural heart disease. Programmatic success and patient outcomes depend on the development of a comprehensive and collaborative program tailored to TAVR.

Transcatheter aortic valve implantation. Expert Consensus of the Association of Cardiovascular Interventions of the Polish Cardiac Society and the Polish Society of Cardio-Thoracic Surgeons, approved by the Board of the Polish Cardiac Society…

“…A reasonably quick patient transfer to a step-down unit enables their earlier mobilisation, self-care, and feeding, resulting in shortening the length of hospital stay (LOS). In advanced centres, the mean LOS of an uncomplicated TAVI is 2-5 days for transfemoral approach and 4-7 days for other access sites used [14]. Based on POL-TAVI registry reports, the mean LOS of an uncomplicated TAVI procedure in Poland is seven days.…”

“…Encouraging results of this novel therapy in prohibitive-, high-, and moderate-risk patients in Poland were possible thanks to the combination of several factors: full support and growing experience of national scientific societies, the introduction of dedicated TAVI programmes in centres with established invasive cardiology and cardiac surgery departments, as well as the organisation of integrated TAVI teams in each of them [13][14][15][16][17][18][19][20][21][22]. The role and indications to SAVR in the future will most probably reflect growing TAVI demand.…”

Transcatheter aortic valve implantation

“…In patients without indications for chronic anticoagula tion, dual antiplatelet therapy is used to prevent thrombosis of the aortic valve prosthesis for 1-6 months after TAVI, using daily maintenance doses of 75-100 mg of ASA (continued indefinitely) and 75 mg of clopidogrel (for up to six months) [28][29][30][31][32][33][34][35].…”

“…The most common complications during this period include bleeding at the vascular access site, other vascular complications, cardiac arrhythmias, stroke, acute heart failure, or respiratory failure [29].…”

“…In experienced TAVI centres, the mean duration of hos pital stay following TAVI procedures is up to five days for the femoral approach and up to seven days for other approaches [29]. Based on the POLTAVI registry data, the mean duration of hospital stay following TAVI procedures in Polish centres is seven days.…”