Steeds, Richard P., Lutz, Matthias, Thambyrajah, Jeetendra, Serra, Antonio, Schulz, Eberhard, Maly, Jiri, Aiello, Marco, Rudolph, Tanja K., Lloyd, Guy, Santo Bortone, Alessandro, Hauptmann, Karl Eugen, Clerici, Alberto, Delle-Karth, Georg, Rieber, Johannes, Indolfi, Ciro, Mancone, Massimo, Belle, Loic, Lauten, Alexander, Arnold, Martin, Bouma, Berto J., Deutsch, Cornelia, Kurucova, Jana, Thoenes, Martin, Bramlage, Peter, Frey, Norbert ORCID: 0000-0001-7611-378X and Messika-Zeitoun, David (2019). Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe. J. Am. Heart Assoc., 8 (19). HOBOKEN: WILEY. ISSN 2047-9980

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Abstract

Background-Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention. The objective was to investigate whether a structured communication to referring physicians (facilitated data relay) might improve the rate and timeliness of intervention. Methods and Results-A prospective registry of consecutive patients with severe aortic stenosis at 23 centers in 9 European countries with transcatheter as well as surgical aortic valve replacement being available was performed. The study included a 3-month documentation of the status quo (phase A), a 6-month intervention phase (implementing facilitated data relay), and a 3-month documentation of a legacy effect (phase-B). Two thousand one hundred seventy-one patients with severe aortic stenoses were enrolled (phase A: 759; intervention: 905; phase-B: 507). Mean age was 77.9 +/- 10.0 years, and 80% were symptomatic, including 52% with severe symptoms. During phase A, intervention was planned in 464/696 (67%), 138 (20%) were assigned to watchful waiting, 8 (1%) to balloon aortic valvuloplasty, 60 (9%) were listed as not for active treatment, and in 26 (4%), no decision was made. Three hundred sixty-three of 464 (78%) patients received the planned intervention within 3 months. Timeliness of the intervention improved as shown by the higher number of aortic valve replacements performed within 3 months (59% versus 51%, P=0.002) and a significant decrease in the time to intervention (36 +/- 38 versus 30 +/- 33 days, P=0.002). Conclusions-A simple, low-cost, facilitated data relay improves timeliness of treatment for patients diagnosed with severe aortic stenosis, resulting in a shorter time to transcatheter aortic valve replacement. This effect was mainly driven by a significant improvement in timeliness of intervention in transcatheter aortic valve replacement but not surgical aortic valve replacement. Clinical Trial Registration-URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02241447.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Steeds, Richard P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lutz, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thambyrajah, JeetendraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Serra, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schulz, EberhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maly, JiriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aiello, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, Tanja K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lloyd, GuyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Santo Bortone, AlessandroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hauptmann, Karl EugenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clerici, AlbertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Delle-Karth, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rieber, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Indolfi, CiroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mancone, MassimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Belle, LoicUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lauten, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnold, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bouma, Berto J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deutsch, CorneliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kurucova, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thoenes, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bramlage, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frey, NorbertUNSPECIFIEDorcid.org/0000-0001-7611-378XUNSPECIFIED
Messika-Zeitoun, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-132125
DOI: 10.1161/JAHA.119.013160
Journal or Publication Title: J. Am. Heart Assoc.
Volume: 8
Number: 19
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 2047-9980
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VALVULAR HEART-DISEASE; VALVE-REPLACEMENT; TASK-FORCE; GUIDELINE ADHERENCE; AMERICAN-COLLEGE; WORKING GROUP; FOLLOW-UP; MANAGEMENT; ASSOCIATION; SOCIETYMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13212

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