The purpose of this study is to narrow the gap between patients being diagnosed with severe aortic stenosis and those being appropriately monitored and treated. For this purpose a prospective survey of current practice (3 months) will be conducted followed by a six month period of intervention during which a variety of quality improvements measures will be implemented. There will then be a 3 month follow-up period during which the legacy of this initiative will be monitored during which no intervention will be carried out.
All patients meeting pre-specified criteria (severe aortic stenosis whether with or without symptoms) will be collected. There will be three phases at each site observation A, intervention, observation B. Observation A: In this phase, the nurse identifies cases with severe AS and collects their data. Baseline data for each patient will be collected and a follow-up will be done after three months for each patient to determine his/her outcome and the treatment that was decided on. There will also be an optional telephone follow-up to find out the patient's outcome. Intervention: In this phase, the physician referring a patient for echocardiography will be notified of a finding of severe aortic stenosis: the nurse brings cases with severe AS to the attention of the referring physician within a week (via phone, e-mail or letter) to make them aware of the diagnosis. Baseline and follow-up data will be collected for each patient as before. Moreover, more detailed data with regard to the patient's health status will be documented. Observation B: Same as Observation Phase A
Study Type
OBSERVATIONAL
Enrollment
2,173
Krankenhaus Hietzing
Vienna, Austria
IKEM - Institute for Clinical and Experimental Medicine
Referral rates at 3 months for Intervention (SAVR or TAVI)
Time frame: 3 months
Referral rates at 3 months for exercise testing or stress echocardiography
Time frame: 3 months
Time to next out-patient appointment or clinical review
Time frame: 15 months
Type of intervention selected (SAVR, TAVI, watchful waiting or no treatment)
Time frame: 3 months
Appropriateness of treatment decisions made in collaboration with the valve specialist
Time frame: 3 months
Outcomes (survival) at 1 year (telephone FU) including the time between diagnosis and treatment
Time frame: 3 months
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