RT Journal Article SR Electronic T1 Differences in the presentation and management of patients with severe aortic stenosis in different European centres JF Open Heart JO Open Heart FD British Cardiovascular Society SP e001345 DO 10.1136/openhrt-2020-001345 VO 7 IS 2 A1 Matthias Lutz A1 David Messika-Zeitoun A1 Tanja K Rudolph A1 Eberhard Schulz A1 Jeetendra Thambyrajah A1 Guy Lloyd A1 Alexander Lauten A1 Norbert Frey A1 Jana Kurucova A1 Martin Thoenes A1 Cornelia Deutsch A1 Peter Bramlage A1 Richard Paul Steeds YR 2020 UL http://openheart.bmj.com/content/7/2/e001345.abstract AB Background An investigation into differences in the management and treatment of severe aortic stenosis (AS) between Germany, France and the UK may allow benchmarking of the different healthcare systems and identification of levers for improvement.Methods Patients with a diagnosis of severe AS under management at centres within the IMPULSE and IMPULSE enhanced registries were eligible.Results Data were collected from 2052 patients (795 Germany; 542 France; 715 UK). Patients in Germany were older (79.8 years), often symptomatic (89.5%) and female (49.8%) and had a lower EF (53.8%) than patients in France and UK. Comorbidities were more common and they had a higher mean Euroscore II.Aortic valve replacement (AVR) was planned within 3 months in 70.2%. This was higher (p<0.001) in Germany than France/ UK. Of those with planned AVR, 82.3% received it within 3 months with a gradual decline (Germany>France> UK; p<0.001). In 253 patients, AVR was not performed, despite planned. Germany had a strong transcatheter aortic valve implantation (TAVI) preference (83.2%) versus France/ UK (p<0.001). Waiting time for TAVI was shorter in Germany (24.9 days) and France (19.5 days) than UK (40.3 days).Symptomatic patients were scheduled for an AVR in 79.4% (Germany> France> UK; p<0.001) and performed in 83.6% with a TAVI preference (73.1%). 20.4% of the asymptomatic patients were intervened.Conclusion Patients in Germany had more advanced disease. The rate of intervention within 3 months after diagnosis was startlingly low in the UK. Asymptomatic patients without a formal indication often underwent an intervention in Germany and France.