Peter F Ludman BCIS National Audit Lead On behalf of British Cardiovascular Intervention Society Basingstoke October 2015
Contents Structure Angio and PCI centres and maps Total angio and PCI numbers No of PCIs per centre and per angio PCI pmp and by country and v CABG Centre PCI volumes PCI operators, by centre, by PPCI On call rotas for PPCI On site v off site surgical cover Day case activity Primary PCI units NICOR data collection Centre participation Databases used Case ascertainment Data completeness Appropriateness Demographics Indication for PCI / Clinical syndrome PPCI activity (by unit, pmp, by vessel) PCI for out of hospital arrest PCI territories / vessels / lesions Stents (BMS and DES) Adjunctive pharmacotherapy LV support and shock Primary PCI for > 80 yrs Extraction / Rota / IVUS / OCT / FFR / Laser etc. Arterial access Process of care Delays to treatment NSTEMI (direct v IHT) Primary PCI DTB / CTB IHT versus Direct admission Length of stay Outcome MACCE Peri-procedural complications and by access Tracked 30 day mortality Outcome by syndrome Outcome by lesion subset Adult non coronary intervention Septal ablation for HOCM Mitral valvuloplasty Mitraclip /PFO / ASD closure / LAA occlusion Para-prosthetic leak closure Renal Denervation Percutaneous Pulmonary valve TAVI Activity by centre Demographics Valve types Delivery approaches by valve type Pacing Complications NICOR IT developments Research Output Public Reports and risk adjusted outcomes Conclusions and summary Appendix: PCI Centre NICOR / CCAD Centre codes
Back to contents TAVI
Transcatheter Valves Case ascertainment
Data extract 01-06-2015 Total = 7,417 2000 1800 1860 1600 1530 1400 1288 Number of TAVI Procedures Performed 1200 1000 800 600 559 780 1039 400 200 0 66 295 2007 2008 2009 2010 2011 2012 2013 2014
Total Procedures by unit and year
Total Procedures by unit and year
Rate pmp by Country
Rate pmp by LAT
UK Survey June 2015 What is the number of patients on your waiting list now for elective TAVI at your centre? 80 70 60 50 40 30 20 10 0 1 3 5 7 9 11 13 15 17 19 21 23 25 Mean 25 Median 19
UK Survey June 2015 What is your current average wait from referral to elective TAVI procedure in your centre. (days) Referral is the time when MDT decides that the patient should be offered TAVI? 300 250 200 150 Mean 87 Median 75 100 50 0 1 3 5 7 9 11 13 15 17 19 21 23 25
UK Survey June 2015 What number of cases have your commissioners agreed to fund this year? 180 160 140 120 100 80 60 40 20 0 1 3 5 7 9 11 13 15 17 19 21 23 25 7: No formal agreement 1: 25 pmp 1: No limit
Female (%)
Mean Age (years)
2007-2014
2007-2014
Mean Logistic EuroSCORE
Diabetic (%)
Renal failure pre TAVI (%) Definition: creatinine > 200, and/or on dialysis
Previous cardiac surgery (%)
Of patients treated by TAVI: Prior Aortic balloon Valvuloplasty
LVEF pre TAVI
Valve Manufacturer
Delivery Approach
Pacing - All Due to TAVI = Pre TAVI in preparation and post TAVI as required
Pacing Edwards Sapien Due to TAVI = Pre TAVI in preparation and post TAVI as required
Pacing Medtronic CoreValve Due to TAVI = Pre TAVI in preparation and post TAVI as required
Complications: CVA up to Dx (%)
Conversion to Surgery in Lab (n) Old Dataset (V3) Emergency surgery New Dataset (V4) Conversion to full Sternotomy Principle reason: 2014 Haemorrhage (14) Valve surgery (10) other (2)
Emergency Valve-in-Valve in lab (n)
Device Embolisation in lab (n)
New Haemofiltration or dialysis post procedure (%)
Mortality (Tracked at 30 days as %)
to treat other valves Mitral 3 2 Number of procedures 2014 1 0 NCR BHL CHN ERI MRI QEB STH Number of centres: 7
to treat other valves Tricuspid 3 2 Number of procedures 2014 1 0 RSC MOR QEB Number of centres: 3
UK PCI Centre Codes 2014 Back to contents
Back to contents UK PCI Centre Codes 2014
UK PCI Centre Codes 2014 Back to contents