# TAVR-leercurve: 76 procedures nodig voor efficiëntere workflow

*geplaatst 2026-11-06 · Algemeen · Indian journal of thoracic and cardiovascular surgery · doi 10.1007/s12055-026-02249-x · https://hartvaat.nl/2026/11/01/tavr-leercurve-76-procedures-nodig-voor-efficientere-workflow/*

Deze retrospectieve single-center studie analyseerde de leercurve van een TAVR-programma in een stedelijke setting met 266 patiënten. De gemiddelde operatietijd daalde significant na 76 procedures (GMR 0,86; p=0,005), wat wijst op een gestroomlijndere workflow en efficiëntere resourcebenutting. Voor structuurhartcentra biedt dit een praktisch benchmarkmoment om de implementatie en operatieve standardisatie te monitoren.

## English: Developing proficiency in a transcatheter aortic valve replacement program: lessons from a single academic center's learning curve.

This retrospective single-center study evaluated the learning curve of a TAVR program across 266 procedures. Operative time decreased significantly after the 76th case (GMR 0.86; p=0.005), indicating improved workflow efficiency and resource utilization. For structural heart teams, reaching this case volume serves as a practical benchmark for program maturation and operative standardization.

## Abstract (original, from the publication)

PURPOSE: Aortic stenosis (AS) is a prevalent and high-mortality valve disease. Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment with outcomes often better than surgery, requiring a multidisciplinary team. This study analyzes outcomes and trends from a high-volume TAVR program in an urban, low-income setting since 2017 to guide future practices. METHODS: Medical records of patients that underwent TAVR were analyzed retrospectively from 2018 to 2023, dividing them into two cohorts to analyze trends in operative details, complications, length of stay (LOS), and readmission/mortality rates. The learning curve (LC) was assessed by operative time. RESULTS: Risk-adjusted cumulative sum (RA-CUSUM) analysis identified the transition point at case 76, dividing the cohort into early LC phase group (n = 76) and post-LC phase group (n = 190). Median operative time decreased from 106 to 80 minutes. After adjustment, operative time was 14% shorter in the post-learning-curve cohort (GMR 0.86, 95% CI 0.77-0.96; p = 0.005). CONCLUSION: Operative time serves as a useful benchmark for institutional maturation. In our program, reaching 76 cases represented a key transition point toward optimized workflows, enhanced efficiency, and improved resource utilization.

Auteurs: Emiliano Gabriel Manueli Laos, Andres Fontaine-Nicola, Lily Zhang, Andrew Carlson, Mario A Masrur, Amer K Ardati, Khalil Ibrahim, Adhir Shroff, Khaled Abdelhady

---
Bron: Indian journal of thoracic and cardiovascular surgery, https://doi.org/10.1007/s12055-026-02249-x. Bijgewerkt 2026-10-30T02:30:58Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.