European Society of Cardiology quality indicators for the care and outcomes of adults undergoing transcatheter aortic valve implantation

Aims To develop a suite of quality indicators (QIs) for the evaluation of the care and outcomes for adults undergoing transcatheter aortic valve implantation (TAVI).Methods and results We followed the European Society of Cardiology (ESC) methodology for the development of QIs. Key domains were identified by constructing a conceptual framework for the delivery of TAVI care. A list of candidate QIs was developed by conducting a systematic review of the literature. A modified Delphi method was then used to select the final set of QIs. Finally, we mapped the QIs to the EuroHeart (European Unified Registries on Heart Care Evaluation and Randomized Trials) data standards for TAVI to ascertain the extent to which the EuroHeart TAVI registry captures information to calculate the QIs. We formed an international group of experts in quality improvement and TAVI, including representatives from the European Association of Percutaneous Cardiovascular Interventions, the European Association of Cardiovascular Imaging, and the Association of Cardiovascular Nursing and Allied Professions. In total, 27 QIs were selected across 8 domains of TAVI care, comprising 22 main (81%) and 5 secondary (19%) QIs. Of these, 19/27 (70%) are now being utilized in the EuroHeart TAVI registry.Conclusion We present the 2023 ESC QIs for TAVI, developed using a standard methodology and in collaboration with ESC Associations. The EuroHeart TAVI registry allows calculation of the majority of the QIs, which may be used for benchmarking care and quality improvement initiatives. Graphical Abstract Central illustration. The 2023 ESC quality indicators for TAVI. AKI, acute kidney injury; AS, aortic stenosis; GA, general anaesthesia; GCCT, gated cardiac computed tomography; MDT, multidisciplinary team; OAC, oral anti-coagulant; PCI, percutaneous coronary intervention; PROMs, patient-reported outcome measures; PVL, paravalvular leak; PPM, permanent pacemaker; QI, quality indicator; SAPT, single antiplatelet therapy; TAVI, transcatheter aortic valve implantation; TF, transfemoral; ViV, valve-in-valve.