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

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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.

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Acknowledgements

The authors are grateful to Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript.

Funding

Device manufacturers partly funded the registry but had no role in data collection or analysis or in manuscript preparation.

Author information

Authors and Affiliations

  1. Department of Cardiology, Rouen University Hospital, Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, 76000, Rouen, France

    Eric Durand, Guillaume Avinée, Christophe Tron, Nicolas Bettinger, Najime Bouhzam & Hélène Eltchaninoff

  2. Department of Biostatistics, CHU de Rouen, 76000, Rouen, France

    André Gillibert

  3. Department of Cardiology, Brest University Hospital, Brest, France

    Martine Gilard

  4. Department of Cardiac Surgery, Rennes University Hospital, Rennes, France

    Jean Philippe Verhoye

  5. Department of Cardiology, Clinique Saint Hilaire, Rouen, France

    René Koning

  6. Department of Cardiology, Ramsay Générale de Santé, Institut Hospitalier Jacques Cartier, Massy, France

    Thierry Lefevre

  7. CHU Lille, Department of Cardiology, Institut Pasteur de Lille, Lille, France

    Eric Van Belle

  8. Cardiothoracic Surgery Department, Institut de Cardiologie, AP-HP, Université Paris 6, Pitié-Salpétrière Hospital, 75013, Paris, France

    Pascal Leprince

  9. Department of Cardiology, INSERM U1148, Paris-Diderot University, Faculté de Médecine Paris-Diderot, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, DHU Fire, Paris, France

    Bernard Iung

  10. Department of Cardiology, Rennes University Hospital, Rennes, France

    Hervé Le Breton

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  1. Eric Durand
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Correspondence to Eric Durand.

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Durand, E., Avinée, G., Gillibert, A. et al. Analysis of length of stay after transfemoral transcatheter aortic valve replacement: results from the FRANCE TAVI registry. Clin Res Cardiol 110, 40–49 (2021). https://doi.org/10.1007/s00392-020-01647-4

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  • DOI: https://doi.org/10.1007/s00392-020-01647-4

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