There is a correlation between the volume of conventional surgical aortic valve replacement procedures and better outcomes in transcatheter aortic valve replacement (TAVR), with higher 30-day and 1-year mortality in sites with lower volume. This is a probable indication that a good surgical team is complemented by a good hemodynamic team and, ultimately, a good…
TCT 2019 | STS/ACC TVT Registry: Relationship Between MitraClip Operator Experience and Events
Courtesy of SBHCI. Mitral valve repair with a MitraClip device is a complex procedure that requires that operators develop a series of skills that may be unusual for them, such as analyzing an echocardiography. In this registry, researchers assessed the relationship between operator experience and procedural outcome. Operators were classified into 3 groups: 1 to 25 procedures…
TAVR Learning Curve and Volume-Outcomes Relationship Plateau
Every operator keeps track of their cases. Have they reached their potential or are they still learning and improving their technique? After 1000 procedures, can we expect them to have better results than someone that has only done 500? Prior studies have reached conflictive results and consequently the relationship between learning curve and volume-outcomes remains…
Increasing operator experience improves TAVR outcomes
The introduction of transcatheter aortic valve replacement (TAVR) into clinical practice in the United States has been a tightly controlled process aimed at optimizing patient outcomes and minimizing the learning curve. Many strategies have been used to reach a rational dispersion for this new technology, including choosing sites with enough volume, and adequate operator training…
PCI Mortality and Volume in One Center: Associated?
The relationship between procedure volume and prognosis after a percutaneous coronary intervention remains unclear. Intuitively, we tend to think the larger the volume, the better the results and, consequently, the lower the mortality. But when analyzing the literature, we find studies for and against this thesis. Evidence does support the idea that volume improves outcomes…
Less volume, more mortality: should we be concerned?
Courtesy of Dr. Agustín Vecchia. In general, guidelines recommend a number of procedures a year for operators to maintain a reasonably safe level of proficiency. Even though this number is arbitrary and operators’ aptitude varies considerable, more than one publication has found an inverse correlation between procedure volume and outcomes. This study incorporated 10,496 operators…