The minimalist approach in transcatheter aortic valve implantation: insights from European healthcare professionals

BACKGROUND: The Minimalist Approach (MA) in Transcatheter Aortic Valve Implantation (TAVI) aims to enhance procedural efficiency while maintaining safety and efficacy. Despite its potential advantages, adoption varies across Europe due to institutional protocols, operator experience, and training availability. This study explores healthcare professionals' perspectives on the MA across European centres. METHODS: A multicentre, cross-sectional survey was conducted among healthcare professionals involved in TAVI across 27 European countries. The questionnaire assessed anaesthesia preferences, use of invasive monitoring, post-procedural management, and formal training in the MA. RESULTS: A total of 119 respondents participated, primarily interventional cardiologists (42.9%) and nurses (33.6%). Formal training in the MA was reported by 41.2% of respondents. Local anaesthesia was the preferred strategy (74.8% strongly agreed, 20.2% agreed). The use of central venous (16%) and urinary catheters (19.3%) was limited among respondents favouring the MA. Early mobilisation (63.9%) and short hospitalisation (58%) were widely supported. Adoption of the MA varied by profession, but all subgroups supported early mobilisation and short hospitalisation. CONCLUSIONS: The MA in TAVI is widely accepted across Europe, particularly regarding anaesthesia and early mobilisation. However, structured training programs remain limited, highlighting the need for standardised education and institutional protocols to ensure broader adoption and optimise patient outcomes.