Evidence map›Paper›PMID 37666643›Full record

ArticleOpen heart2023

Time to TAVI: streamlining the pathway to treatment.

Lynsey Jane Hewitson, Suzane Cadiz, Sameeha Al-Sayed, Sarah Fellows, Alaaeldin Amin, George Asimakopoulos, Edward Barnes, Andrew Beale, Suzy Browne, Badrinathan Chandrasekaran and 18 more

Open access · goldAbstract read
In one paragraph

Article in Open heart, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Fighting time: the critical importance of pre-TAVR mortality risk prediction.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 3 institutions in 1 country.

Lynsey Jane Hewitson *Great Western Hospitals NHS Foundation Trust, Swindon, UK lynsey.hewitson@nhs.net.ORCID 0000-0003-3361-0713
Suzane Cadiz *Royal Brompton & Harefield NHS Foundation Trust, London, UK.
Sameeha Al-SayedRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Sarah FellowsGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Alaaeldin AminGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
George AsimakopoulosRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Edward BarnesGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Andrew BealeGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Suzy BrowneRoyal Brompton & Harefield NHS Foundation Trust, London, UK.ORCID 0000-0002-3706-648X
Badrinathan ChandrasekaranGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Miles DalbyRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Paul FoleyGreat Western Hospitals NHS Foundation Trust, Swindon, UK.ORCID 0000-0002-4856-832X
Mark HawkinsGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Douglas HaynesGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Ee Ling HengRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Tom HydeGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Tito KabirRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Ali KhavandiRoyal United Hospitals Bath NHS Foundation Trust, Bath, UK.
Saeed MirsadraeeRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
William McCreaGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Mario PetrouRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Roxy SeniorRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
David SmithRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Robert SmithRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Marco SparteraGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Malgorzata WamilGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Vasileios PanoulasRoyal Brompton & Harefield NHS Foundation Trust, London, UK.
Hazim RahbiGreat Western Hospitals NHS Foundation Trust, Swindon, UK.
Royal Brompton & Harefield NHS Foundation Trust · GBGreat Western Hospitals NHS Foundation Trust · GBRoyal United Hospital Bath NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSevere aortic stenosis is a major cause of morbidity and mortality. The existing treatment pathway for transcatheter aortic valve implantation (TAVI) traditionally relies on tertiary Heart Valve Centre workup. However, this has been associated with delays to treatment, in breach of British Cardiovascular Intervention Society targets. A novel pathway with emphasis on comprehensive patient workup at a local centre, alongside close collaboration with a Heart Valve Centre, may help reduce the time to TAVI.

methodsThe centre performing local workup implemented a novel TAVI referral pathway. Data were collected retrospectively for all outpatients referred for consideration of TAVI to a Heart Valve Centre from November 2020 to November 2021. The main outcome of time to TAVI was calculated as the time from Heart Valve Centre referral to TAVI, or alternative intervention, expressed in days. For the centre performing local workup, referral was defined as the date of multidisciplinary team discussion. For this centre, a total pathway time from echocardiographic diagnosis to TAVI was also evaluated. A secondary outcome of the proportion of referrals proceeding to TAVI at the Heart Valve Centre was analysed.

resultsMean±SD time from referral to TAVI was significantly lower at the centre performing local workup, when compared with centres with traditional referral pathways (32.4±64 to 126±257 days, p<0.00001). The total pathway time from echocardiographic diagnosis to TAVI for the centre performing local workup was 89.9±67.6 days, which was also significantly shorter than referral to TAVI time from all other centres (p<0.003). Centres without local workup had a significantly lower percentage of patients accepted for TAVI (49.5% vs 97.8%, p<0.00001). DISCUSSION: A novel TAVI pathway with emphasis on local workup within a non-surgical centre significantly reduced both the time to TAVI and rejection rates from a Heart Valve Centre. If adopted across the other centres, this approach may help improve access to TAVI.

Indexed as

Transcatheter Aortic Valve ReplacementEchocardiographyHumansOutpatientsReferral and ConsultationRetrospective StudiesAortic Valve StenosisDelivery of Health CareDiagnostic ImagingEpidemiologyTranscatheter Aortic Valve Replacement

Identifiers

PMID37666643
PMCPMC10481834
OpenAlexW4386415869

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.