title: [The role of learning curve on the results of aortic valve implantation for severe aortic stenosis].
abstract: BACKGROUND
  Patients with serious aortic stenoses treated by conservative therapy have significantly worse life expectancy. Besides the surgical aortic valve replacement (AVR) as the gold standard of therapy, the transcatheter aortic valve implantation (TAVI) is indicated in patients at very high risk or who are contraindicated to AVR. The role of learning-curve in TAVI has to be established.
  
  
  OBJECTIVE
  Assessment of the results of consecutive TAVI procedures based on the experience of the team.
  
  
  METHODS
  58 high-risk consecutive patients with the average age of 82.2 years were divided into 3 groups based on the TAVI order ( 20., 21.-40., 41.-58.). After the Edwards SAPIEN implantation via transfemoral or transapical approaches, all patients were followed for minimum 30 days. Data from the national registry (Czech TAVI Registry) were used for the retrospective analysis. Comparison of the groups was done by using the Kruskal-Wallis test, Mann-Whitney U test and χ2 test.
  
  
  RESULTS
  Significantly shorter procedural time (p < 0.001), hospitalization (p = 0.033) and a lower amount of contrast medium (p < 0.001) was observed during the time. There was no difference in the rate of clinical complications at 30 days.
  
  
  CONCLUSIONS
  Increasing experience of the TAVI implantation team is associated with significantly shorter procedural time, hospitalization and a lower amount of contrast medium. Overall very good clinical results during 30 days were not affected by the team experience.
authors.forename: Petr
authors.initials: P
authors.lastname: Kala
authors.forename: Petr
authors.initials: P
authors.lastname: Němec
authors.forename: Petr
authors.initials: P
authors.lastname: Malík
authors.forename: Jiří
authors.initials: J
authors.lastname: Ondrášek
authors.forename: Martin
authors.initials: M
authors.lastname: Třetina
authors.forename: Petr
authors.initials: P
authors.lastname: Pokorný
authors.forename: Jiří
authors.initials: J
authors.lastname: Jarkovský
authors.forename: Milan
authors.initials: M
authors.lastname: Bláha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002983:Clinical Competence; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D059032:Learning Curve; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome