Valvular & structural heart disease
Association between quality of care indicators and clinical outcomes in patients undergoing transcatheter aortic valve implantation: insights from SWEDEHEART
Authors' conclusion
In this study, the majority of the QIs were associated with both all-cause and cardiovascular mortality. Hence, the ESC 2023 QIs for TAVI may serve as a valuable tool for evaluating TAVI care, benchmarking performance, and improving patient outcomes.
Study context
- Population
- Patients undergoing transcatheter aortic valve implantation (TAVI) in Swedenpatients (median 82 years, 52.8% male), TAVI procedures in Swedish centres (n = 8)
- Participants
- 8,524 patients
- Exposure
- Attainment of the European Society of Cardiology (ESC) 2023 quality indicators (QIs) for TAVI and its association with 1-year mortality
- Outcome
- QIs captured from registry data
Methodological detailsSwedish Transcatheter Cardiac Intervention Registry, all TAVI procedures in Swedish centres, 2008–2021
- Swedish Transcatheter Cardiac Intervention Registry
- All TAVI procedures in Swedish centres
- 2008–2021
Main finding
As reported in the abstract
QIs captured of the 27 QIs
24
88.8%
Observational data: associations, not effects.
Further findings
QI attainment levels
- Overall attainment
- median 97.8%, interquartile range (IQR) 91.3-100%
- QIs related to transfemoral route
- median 90.3%, IQR 85.6-96.9%
- Transfemoral TAVI without general anaesthesia
- median 87.6%, IQR 57.1-94.4%
- Small variations in attainment levels between centres
Association of QIs with mortality · 1 year
- QIs associated with 1-year all-cause mortality
- 80%
- QIs associated with 1-year cardiovascular mortality
- 85%
QIs with greatest impact on 1-year mortality
- Absence of coronary obstruction, adjusted HR (95% CI)
- 0.12; 95% CI 0.07-0.22
- In-hospital stroke, adjusted HR (95% CI)
- 0.25; 95% CI 0.18-0.33
- No new dialysis, adjusted HR (95% CI)
- 0.25; 95% CI 0.15-0.41
Original publication
Association between quality of care indicators and clinical outcomes in patients undergoing transcatheter aortic valve implantation: insights from SWEDEHEART. Eur Heart J Qual Care Clin Outcomes. Published 3 December 2025. doi:10.
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