Top

Published in:

01-01-2021 | Aortic Valve Replacement | Original Paper

Analysis of length of stay after transfemoral transcatheter aortic valve replacement: results from the FRANCE TAVI registry

Authors: Eric Durand, Guillaume Avinée, André Gillibert, Christophe Tron, Nicolas Bettinger, Najime Bouhzam, Martine Gilard, Jean Philippe Verhoye, René Koning, Thierry Lefevre, Eric Van Belle, Pascal Leprince, Bernard Iung, Hervé Le Breton, Hélène Eltchaninoff

Published in: Clinical Research in Cardiology | Issue 1/2021

Abstract

Background

Currently, there are no recommendations regarding the minimum duration of in-hospital monitoring after transfemoral (TF) transcatheter aortic valve replacement (TAVR) and practices are extremely heterogeneous. We, therefore, aimed to evaluate length of stay (LOS) and predictive factors for late discharge after TF TAVR using data from the FRANCE TAVI registry.

Methods

TAVR was performed in 12,804 patients in 48 French centers between 2013 and 2015. LOS was evaluated in 5857 TF patients discharged home. LOS was calculated from TAVR procedure (day 0) to discharge. The study population was divided into three groups based on LOS values. Patients discharged within 3 days constituted the “very early” discharge group, patients with a LOS between 3 and 6 days constituted the “early” discharge group, and patients with a length of stay > 6 days constituted the “late” discharge group.

Results

The median LOS was 7 (5–9) days and was extremely variable among centers. The proportion of patients discharged very early, early, and late was 4.4% (n = 256), 33.7% (n = 1997), and 61.9% (n = 3624) respectively. Variables associated with late discharge were female sex, co-morbidities, major complications, self-expandable valve, general anesthesia, and a significant center effect. In contrast, history of previous pacemaker was a protective factor. The composite of death and re-admission in the very early and early versus late discharge groups was similar at 30 days (3.3% vs. 3.5%, p = 0.66).

Conclusions

LOS is extremely variable after TF TAVR in France. Co-morbidities and complications were predictive factors of late discharge after TAVI. Interestingly, the use of self-expandable prosthesis and general anesthesia may also contribute to late discharge. Our results confirm that early discharge is safe.

Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL, ESC Scientific Document Group (2017) ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 38:2739–2791CrossRef

Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A (2017) AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation 135:e1159–e1195CrossRef

Kappetein AP, Head SJ, Généreux P, Piazza N, van Mieghem NM, Blackstone EH, Brott TG, Cohen DJ, Cutlip DE, van Es GA, Hahn RT, Kirtane AJ, Krucoff MW, Kodali S, Mack MJ, Mehran R, Rodés-Cabau J, Vranckx P, Webb JG, Windecker S, Serruys PW, Leon MB (2012) Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. J Am Coll Cardiol 60:1438–1454CrossRef

Durand E, Borz B, Godin M, Tron C, Litzler PY, Bessou JP, Bejar K, Fraccaro C, Sanchez-Giron C, Dacher JN, Bauer F, Cribier A, Eltchaninoff H (2012) Transfemoral aortic valve replacement with the Edwards SAPIEN and Edwards SAPIEN XT prosthesis using exclusively local anesthesia and fluoroscopic guidance: feasibility and thirty-day outcomes. JACC Cardiovasc Interv 5:461–467CrossRef

Durand E, Eltchaninoff H, Canville A, Bouhzam N, Godin M, Tron C, Rodriguez C, Litzler PY, Bauer F, Cribier A (2015) Feasibility and safety of early discharge after transfemoral transcatheter aortic valve implantation with the Edwards SAPIEN-XT prosthesis. Am J Cardiol 115:1116–1122CrossRef

Serletis-Bizios A, Durand E, Cellier G, Tron C, Bauer F, Glinel B, Dacher JN, Cribier A, Eltchaninoff H (2016) A prospective analysis of early discharge after transfemoral transcatheter aortic valve implantation. Am J Cardiol 118:866–872CrossRef

Barbanti M, Capranzano P, Ohno Y, Attizzani GF, Gulino S, Immè S, Cannata S, Aruta P, Bottari V, Patanè M, Tamburino C, Di Stefano D, Deste W, Giannazzo D, Gargiulo G, Caruso G, Sgroi C, Todaro D, di Simone E, Capodanno D, Tamburino C (2015) Early discharge after transfemoral transcatheter aortic valve implantation. Heart 101:1485–1490CrossRef

Kamioka N, Wells J, Keegan P, Lerakis S, Binongo J, Corrigan F, Condado J, Patel A, Forcillo J, Ogburn L, Dong A, Caughron H, Simone A, Leshnower B, Devireddy C, Mavromatis K, Guyton R, Stewart J, Thourani V, Block PC, Babaliaros V (2018) Predictors and clinical outcomes of next-day discharge after minimalist transfemoral transcatheter aortic valve replacement. JACC Cardiovasc Interv 11:107–115CrossRef

Kotronias RA, Teitelbaum M, Webb JG, Mylotte D, Barbanti M, Wood DA, Ballantyne B, Osborne A, Solo K, Kwok CS, Mamas MA, Bagur R (2018) Early versus standard discharge after transcatheter aortic valve replacement: a systematic review and meta-analysis. JACC Cardiovasc Interv 11:1759–1771CrossRef

10.

Barbanti M, van Mourik MS, Spence MS, Icovelli F, Martinelli GL, Muir DF, Saia F, Bortone AS, Densem CG, van der Kley F, Bramlage P, Vis M, Tamburino C (2019) Optimizing patient discharge management after transfemoral transcatheter aortic valve implantation: the multicentre European FAST-TAVI trial. EuroIntervention 15:147–154CrossRef

11.

Wood DA, Lauck SB, Cairns JA, Humphries KH, Cook R, Welsh R, Leipsic J, Genereux P, Moss R, Jue J, Blanke P, Cheung A, Ye J, Dvir D, Umedaly H, Klein R, Rondi K, Poulter R, Stub D, Barbanti M, Fahmy P, Htun N, Murdoch D, Prakash R, Barker M, Nickel K, Thakkar J, Sathananthan J, Tyrell B, Al-Qoofi F, Velianou JL, Natarajan MK, Wijeysundera HC, Radhakrishnan S, Horlick E, Osten M, Buller C, Peterson M, Asgar A, Palisaitis D, Masson JB, Kodali S, Nazif T, Thourani V, Babaliaros VC, Cohen DJ, Park JE, Leon MB, Webb JG (2019) The vancouver 3M (multidisciplinary, multimodality, but minimalist) clinical pathway facilitates safe next-day discharge home at low-, medium-, and high-volume transfemoral transcatheter aortic valve replacement centers: the 3M TAVR study. JACC Cardiovasc Interv 12:459–469CrossRef

12.

Auffret V, Lefevre T, Van Belle E, Eltchaninoff H, Iung B, Koning R, Motreff P, Leprince P, Verhoye JP, Manigold T, Souteyrand G, Boulmier D, Joly P, Pinaud F, Himbert D, Collet JP, Rioufol G, Ghostine S, Bar O, Dibie A, Champagnac D, Leroux L, Collet F, Teiger E, Darremont O, Folliguet T, Leclercq F, Lhermusier T, Olhmann P, Huret B, Lorgis L, Drogoul L, Bertrand B, Spaulding C, Quilliet L, Cuisset T, Delomez M, Beygui F, Claudel JP, Hepp A, Jegou A, Gommeaux A, Mirode A, Christiaens L, Christophe C, Cassat C, Metz D, Mangin L, Isaaz K, Jacquemin L, Guyon P, Pouillot C, Makowski S, Bataille V, Rodés-Cabau J, Gilard M, Le Breton H, FRANCETAVI Investigators (2017) Temporal trends in transcatheter aortic valve replacement in France: FRANCE 2 to 1 FRANCE TAVI. J Am Coll Cardiol 70:42–55CrossRef

13.

Gilard M, Eltchaninoff H, Iung B, Donzeau-Gouge P, Chevreul K, Fajadet J, Leprince P, Leguerrier A, Lievre M, Prat A, Teiger E, Lefevre T, Himbert D, Tchetche D, Carrié D, Albat B, Cribier A, Rioufol G, Sudre A, Blanchard D, Collet F, Dos Santos P, Meneveau N, Tirouvanziam A, Caussin C, Guyon P, Boschat J, Le Breton H, Collart F, Houel R, Delpine S, Souteyrand G, Favereau X, Ohlmann P, Doisy V, Grollier G, Gommeaux A, Claudel JP, Bourlon F, Bertrand B, Van Belle E, Laskar M, FRANCE 2 Investigators (2012) Registry of transcatheter aortic-valve implantation in high-risk patients. N Engl J Med 366:1705–1715CrossRef

14.

Grover FL, Vemulapalli S, Carroll JD, Edwards FH, Mack MJ, Thourani VH, Brindis RG, Shahian DM, Ruiz CE, Jacobs JP, Hanzel G, Bavaria JE, Tuzcu EM, Peterson ED, Fitzgerald S, Kourtis M, Michaels J, Christensen B, Seward WF, Hewitt K, Holmes DR Jr, STS/ACC TVT Registry (2017) 2016 Annual report of the Society of Thoracic Surgeons/American College of Cardiology transcatheter valve therapy registry. J Am Coll Cardiol 69:1215–1230CrossRef

15.

Mirolo A, Viart G, Durand E, Savouré A, Godin B, Auquier N, Raitière O, Eltchaninoff H, Anselme F (2018) Pacemaker memory in post-TAVI patients: who should benefit from permanent pacemaker implantation? Pacing Clin Electrophysiol 41:1178–1184CrossRef

16.

Rodés-Cabau J, Ellenbogen KA, Krahn AD, Latib A, Mack M, Mittal S, Muntané-Carol G, Nazif TM, Sondergaard L, Urena M, Windecker S, Philippon F (2019) Management of conduction disturbances associated with transcatheter aortic valve replacement: JACC scientific expert panel. J Am Coll Cardiol 74:1086–1106CrossRef

17.

Mallikethi-Reddy S, Akintoye E, Telila T, Sudhakar R, Jagadeesh K, Briasoulis A, Rubenfire M, Afonso L, Grines CL (2017) Transcatheter aortic valve implantation in the United States: predictors of early hospital discharge. J Interv Cardiol 30:149–155CrossRef

18.

Eskandari M, Aldalati O, Dworakowski R, Byrne JA, Alcock E, Wendler O, MacCarthy PA, Ludman PF, Hildick-Smith DJR, Monaghan MJ, UK TAVI Steering Committee, and the National Institute for Cardiovascular Outcome Research (2018) Comparison of general anaesthesia and non-general anaesthesia approach in transfemoral transcatheter aortic valve implantation. Heart 104:1621–1628CrossRef

19.

Husser O, Fujita B, Hengstenberg C, Frerker C, Beckmann A, Möllmann H, Walther T, Bekeredjian R, Böhm M, Pellegrini C, Bleiziffer S, Lange R, Mohr F, Hamm CW, Bauer T, Ensminger S, Executive Board GARY (2018) Conscious sedation versus general anesthesia in transcatheter aortic valve replacement: the German aortic valve registry. JACC Cardiovasc Interv 11:567–578CrossRef

20.

Ehret C, Rossaint R, Foldenauer AC, Stoppe C, Stevanovic A, Dohms K, Hein M, Schälte G (2017) Is local anaesthesia a favourable approach for transcatheter aortic valve implantation? A systematic review and meta-analysis comparing local and general anaesthesia. BMJ Open 7:e016321CrossRef

21.

Wijeysundera HC, Qiu F, Koh M, Prasad TJ, Cantor WJ, Cheema A, Chu MW, Czarnecki A, Feindel C, Fremes SE, Kingsbury KJ, Natarajan MK, Peterson M, Ruel M, Strauss B, Ko DT (2017) Comparison of outcomes of balloon-expandable versus self-expandable transcatheter heart valves for severe aortic stenosis. Am J Cardiol 119:1094–1099CrossRef

22.

Abdel-Wahab M, Mehilli J, Frerker C, Neumann FJ, Kurz T, Tölg R, Zachow D, Guerra E, Massberg S, Schäfer U, El-Mawardy M, Richardt G, for the CHOICE investigators (2014) Comparison of balloon-expandable vs. self-expandable valves in patients undergoing transcatheter aortic valve replacement: the CHOICE randomized clinical trial. JAMA 311:1503–1514CrossRef

23.

Thiele H, Kurz T, Feistritzer HJ, Stachel G, Hartung P, Eitel I, Marquetand C, Nef H, Doerr O, Lauten A, Landmesser U, Abdel-Wahab M, Sandri M, Holzhey D, Borger M, Ince H, Öner A, Meyer-Saraei R, Wienbergen H, Fach A, Frey N, König IR, Vonthein R, Rückert Y, Funkat AK, de Waha-Thiele S, Desch S (2020) Comparison of newer generation self-expandable vs. balloon-expandable valves in transcatheter aortic valve implantation: the randomized SOLVE-TAVI trial. Eur Heart J. https://doi.org/10.1093/eurheartj/ehaa036 (Epub ahead of print)CrossRefPubMed

24.

Vendrik J, Vlastra W, van Mourik MS, Delewi R, Beijk MA, Lemkes J, Wykrzykowska JJ, de Winter RJ, Henriques JS, Piek JJ, Vis MM, Koch KT, Baan J Jr (2020) Early mobilisation after transfemoral transcatheter aortic valve implantation: results of the MobiTAVI trial. Neth Heart J. https://doi.org/10.1007/s12471-020-01374-5(Epub ahead of print)CrossRefPubMedPubMedCentral

Title: Analysis of length of stay after transfemoral transcatheter aortic valve replacement: results from the FRANCE TAVI registry
Authors: Eric Durand
Guillaume Avinée
André Gillibert
Christophe Tron
Nicolas Bettinger
Najime Bouhzam
Martine Gilard
Jean Philippe Verhoye
René Koning
Thierry Lefevre
Eric Van Belle
Pascal Leprince
Bernard Iung
Hervé Le Breton
Hélène Eltchaninoff
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Aortic Valve Replacement
Transcatheter Aortic Valve Implantation
Aortic Valve Replacement
Aortic Valve Replacement
General Anesthesia
Pacemaker
Pacemaker
Pacemaker
Published in: Clinical Research in Cardiology / Issue 1/2021
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-020-01647-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Analysis of length of stay after transfemoral transcatheter aortic valve replacement: results from the FRANCE TAVI registry

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Noncalcified plaque burden quantified from coronary computed tomography angiography improves prediction of side branch occlusion after main vessel stenting in bifurcation lesions: results from the CT-PRECISION registry

Correction to: Protected risk stratification with the wearable cardioverter-defibrillator: results from the WEARIT-II-EUROPE registry

One- and 3-year outcomes of percutaneous bifurcation left main revascularization with modern drug-eluting stents: a systematic review and meta-analysis

Hypothermia in patients with acute myocardial infarction: a meta-analysis of randomized trials

Left atrial appendage closure in patients with chronic kidney disease: results from the German multicentre LAARGE registry

Cryoballoon pulmonary vein isolation-mediated rise of sinus rate in patients with paroxysmal atrial fibrillation