Review of Transcatheter Aortic Valve Insertion (TAVI) Clinician Opinions on the Canadian Cardiovascular Society Post-TAVI Driving Guidelines
Bibliographic record
Abstract
Background: As compared to surgical aortic valve replacement, transcatheter aortic valve insertion (TAVI) has a lower perioperative risk and an abbreviated recovery. In the absence of robust clinical data to guide decision-making, the Canadian Cardiovascular Society has now recommended the same 1-month driving restriction for both procedures. Methods: In April 2024, a 15-question survey was circulated to all 31 Canadian TAVI centres to explore opinions on the current driving recommendations and the safety of driving post TAVI, with the goal of informing updated expert-informed guidelines. Results: Of 31 TAVI centres, 29 individuals from 25 centres (80.6%) provided responses. The majority (79.3%) expressed that a 1-month driving prohibition was "too long," and 20.7% stated that this restriction was appropriate. When asked to suggest a new post-TAVI driving recommendation for successful, uncomplicated, transfemoral TAVI patients, 41.4% proposed that patients be prohibited from driving for 2 weeks, 24.1% suggested 1 week, 13.8% were supportive of 1 month, and 6.9% were supportive of either 3 weeks, 72 hours, or 48 hours. The predominant driving-related concern was the development of conduction abnormalities (89.7%). A longer driving prohibition (≥ 1 month) was suggested in cases of alternative-access TAVI (transapical: 67.7%; alternative arterial: 51.6%), access-site and/or vascular complications (48.4%), and conduction abnormalities without a pacemaker (45.2%). Conclusions: The majority of Canadian TAVI programs expressed that a 1-month driving restriction period was overly cautious and that shorter restriction periods would be more appropriate. Ultimately, before any change to post-TAVI driving restrictions may be considered, a clinical assessment of patient recovery post TAVI is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.048 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.010 | 0.015 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".