{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:56:10Z","timestamp":1755795370645,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,11,25]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Increasing demand for transcatheter aortic valve implantation (TAVI) places greater emphasis on the efficiency of pathways and services. A significant limitation to increasing TAVI capacity is the availability of cardiac catheterisation laboratory time. We have developed a novel complexity scoring system (TAVI ComplEXity; TEX score) which can aid in planning lists with appropriate case selection. To validate the TEX score, we have undertaken a retrospective analysis of TAVI cases. The hypothesis is that increasing TEX score correlates with increased procedural duration and reduced valve academic research consortium (VARC) 3 technical and device success.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The TEX score assigns patients to a complexity level of 1 (low), 2 (intermediate) or 3 (high) based on the presence of specific clinical and anatomical variables. For validation purposes, comparisons were made between patients in the three complexity levels with respect to procedural duration as well as VARC-3 technical success, device success and early safety.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The validation study included 1034 consecutive patients who underwent TAVI between June 2021 and October 2023. Of these, 582 (56.3%) were classified as level 1 complexity, 377 (36.5%) level 2 and 75 (7.3%) level 3. Significant differences were observed between the three groups with respect to procedural duration (73.7 min vs 85.6 min vs 136 min; p&lt;0.001), VARC-3 technical success (97.9% vs 96.6% vs 92%; p&lt;0.05) and VARC-3 device success (96.2% vs 92.3% vs 86.6%; p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The TEX score is a simple tool which allows stratification of patients into three levels of complexity. Increasing complexity levels correlate with increasing procedural duration and reduced VARC-3 technical and device success. This is potentially useful for scheduling patients onto appropriate lists.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002804","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T23:15:13Z","timestamp":1736032513000},"page":"e002804","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transcatheter aortic valve implantation complexity score"],"prefix":"10.1136","volume":"12","author":[{"given":"Amr","family":"Abdelrahman","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bamford","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"},{"name":"The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suleman","family":"Aktaa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rowan","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sacchin","family":"Arockiam","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J","family":"Blackman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Malkin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Cunnington","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9597-4451","authenticated-orcid":false,"given":"Noman","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds General Infirmary, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"2025081711171086000_12.1.e002804.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"2025081711171086000_12.1.e002804.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"2025081711171086000_12.1.e002804.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307447"},{"key":"2025081711171086000_12.1.e002804.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.595"},{"key":"2025081711171086000_12.1.e002804.5","unstructured":"Ludman PF . BCIS national audit adult interventional procedures 1st april 2021 to 31st march 2022. London BCIS Advanced Cardiovascular Intervention; 2023."},{"key":"2025081711171086000_12.1.e002804.6","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2021-001783","article-title":"Uncovering the treatable burden of severe aortic stenosis in the UK","volume":"9","author":"Strange","year":"2022","journal-title":"Open Heart"},{"key":"2025081711171086000_12.1.e002804.7","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2020-001547","article-title":"\u201cValve for Life\u201d: tackling the deficit in transcatheter treatment of heart valve disease in the UK","volume":"8","author":"Ali","year":"2021","journal-title":"Open Heart"},{"key":"2025081711171086000_12.1.e002804.8","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-021-02347-1"},{"key":"2025081711171086000_12.1.e002804.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.06.015"},{"key":"2025081711171086000_12.1.e002804.10","first-page":"110","article-title":"Left ventricular dysfunction before transcatheter aortic valve implantation","volume":"5","author":"Hayashida","year":"2019","journal-title":"Asia Interv"},{"key":"2025081711171086000_12.1.e002804.11","doi-asserted-by":"crossref","DOI":"10.1111\/eci.13491","article-title":"The Iliofemoral tortuosity score predicts access and bleeding complications during transfemoral transcatheter aortic valve replacement: DataData from the VIenna Cardio Thoracic aOrtic valve registrY (VICTORY)","volume":"51","author":"Mach","year":"2021","journal-title":"Eur J Clin Invest"},{"key":"2025081711171086000_12.1.e002804.12","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV10I6A126"},{"key":"2025081711171086000_12.1.e002804.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.07.020"},{"key":"2025081711171086000_12.1.e002804.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.017"},{"key":"2025081711171086000_12.1.e002804.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.02.042"},{"key":"2025081711171086000_12.1.e002804.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.01.002"},{"key":"2025081711171086000_12.1.e002804.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.039"},{"key":"2025081711171086000_12.1.e002804.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.03.024"},{"key":"2025081711171086000_12.1.e002804.19","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx455"},{"key":"2025081711171086000_12.1.e002804.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.02.030"},{"key":"2025081711171086000_12.1.e002804.21","unstructured":"BCIS national tavi audit data, presented at aci. 2023."},{"key":"2025081711171086000_12.1.e002804.22","doi-asserted-by":"crossref","unstructured":"Grazina A , Lacerda Teixeira B , Ramos R , et al . Transcatheter aortic valve implantation via percutaneous alternative access routes: outcomes. RECICE 2024. doi:10.24875\/RECICE.M23000389","DOI":"10.24875\/RECICE.M23000389"},{"key":"2025081711171086000_12.1.e002804.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.08.035"},{"key":"2025081711171086000_12.1.e002804.24","doi-asserted-by":"crossref","DOI":"10.15420\/icr.2021.19","article-title":"Transcatheter Aortic Valve Implantation for Severe Pure Aortic Regurgitation With Dedicated Devices","volume":"17","author":"Costanzo","year":"2022","journal-title":"Interv Cardiol"},{"key":"2025081711171086000_12.1.e002804.25","unstructured":"ISPM \u2013 University of Bern . STROBE statement. 2018. Available: https:\/\/ www.strobe-statement.org\/index.php?id=strobe-home [Accessed 12 Dec 2023]."},{"key":"2025081711171086000_12.1.e002804.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.02.038"},{"key":"2025081711171086000_12.1.e002804.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.06.040"},{"key":"2025081711171086000_12.1.e002804.28","doi-asserted-by":"crossref","DOI":"10.1002\/hsr2.283","article-title":"Risk scores for prediction of 30-day mortality after transcatheter aortic valve implantation: Results from a two-center study in Norway","volume":"4","author":"Kj\u00f8n\u00e5s","year":"2021","journal-title":"Health Sci Rep"},{"key":"2025081711171086000_12.1.e002804.29","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-11788-3","article-title":"TAVI-CT score to evaluate the anatomic risk in patients undergoing transcatheter aortic valve implantation","volume":"12","author":"Corcione","year":"2022","journal-title":"Sci Rep"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2024-002804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T18:17:19Z","timestamp":1755454639000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2024-002804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,4]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/openhrt-2024-002804"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2024-002804","relation":{},"ISSN":["2053-3624"],"issn-type":[{"type":"electronic","value":"2053-3624"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}