(A) CUSUM analysis for the primary end point (VARC-2 safety end point at 30 days composite of: death, stroke, life-threatening bleeding, major vascular.

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(A) CUSUM analysis for the primary end point (VARC-2 safety end point at 30 days composite of: death, stroke, life-threatening bleeding, major vascular complications, AKI stage 2–3 and valve-related dysfunction requiring a repeat procedure), showing in-cont... (A) CUSUM analysis for the primary end point (VARC-2 safety end point at 30 days composite of: death, stroke, life-threatening bleeding, major vascular complications, AKI stage 2–3 and valve-related dysfunction requiring a repeat procedure), showing in-control procedure. Formal proficiency was obtained at operation n.54 when the cumulative failure curve crossed the predicted lower reference (estimated 20%). (B) CUSUM analysis for the primary end point for Edwards balloon-expandable valves (n=126) and CoreValve self-expandable valves (n=51). Formal proficiency was obtained at operation n.50 for Edwards (yellow line) and operation n. 36 for CoreValve (red line) prostheses. Of note, our centre began the TAVI programme with Edwards devices; therefore, early CoreValve implants may have benefited from the acquired experience. (C) CUSUM analysis for secondary end point (VARC-2 device non-success). Acceptable event rate was set to 10% and the total number of failures were six. Proficiency level for this end point was formally reached after 32 cases. AKI, acute kidney injury; CUSUM, Cumulative Sum of failures Analysis; TAVI, transcatheter aortic valve implantation; VARC-2, Valve Academic Research Consortium. Mattia Lunardi et al. Open Heart 2016;3:e000420 ©2016 by British Cardiovascular Society