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Since the first implantation of a percutaneous aortic bioprosthesis (TAVI) in 2002 (Cribier et al. Circulation 2002), TAVI occupies an increasing place in the management of aortic stenosis (AR) . Initially reserved for inoperable patients at high surgical risk, TAVI is also recommended in patients at intermediate risk, especially when a femoral approach (TF) is possible (Baumgartner et al. Eur Heart J. 2017).
Currently, there is no recommendation regarding length of stay after TAVI and practices are extremely heterogeneous. Despite the growing experience of centers, better patient selection and a reduction in complications, the length of stay after TAVI remains very high in France.
Faced with the great disparity observed between the centers, efforts are necessary to educate the centers in order to further reduce the length of stay after TF-TAVI. The aim of the study is to evaluate the effectiveness of an intervention based on training teams to reduce the length of stay after TF-TAVI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental | The randomized centres in this group will be follow a training dedicated on implementation of "organizational" and "therapeutic" measures (for prevention and management of complications) to reduce lenght-of-stay after TF TAVI. |
|
| Control group | No Intervention | The randomized centres in this group will not change their practices. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Training | Other | Training dedicated on implementation of "organizational" and "therapeutic" measures (for prevention and management of complications) to reduce lenght-of-stay after TF TAVI. |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the effectiveness of a multi-component organizational intervention | Proportion of patients benefiting from TF-TAVI with a length of stay less than or equal to 3 days. | Year 1 |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the safety of the intervention | This outcome will be evaluated using :
| Day 30 |
| To evaluate the budgetary impact of the intervention |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU d'Amiens | Amiens | France | ||||
| CHU d'Angers |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38437633 | Derived | Durand E, Beziau-Gasnier D, Michel M, Iung B, Tchetche D, Bonnet G, Lhermusier T, Gilard M, Souteyrand G, Bouleti C, Ohlmann P, Lefevre T, Beygui F, Chassaing S, Chevreul K, Eltchaninoff H; FAST-TAVI II; STOP-AS investigators. Reducing length of stay after transfemoral transcatheter aortic valve implantation: the FAST-TAVI II trial. Eur Heart J. 2024 Mar 14;45(11):952-962. doi: 10.1093/eurheartj/ehae081. |
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In this study, there is a randomization of the participating centres in two groups.
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This outcome will be assessed using:
| Year 1 |
| To evaluate the implementation of the intervention | This outcome will be evaluated using the rate of adherence of the centers to the procedures aiming to reduce the length of stay (questionnaires) | Year 1 |
| To identify the factors associated with the effectiveness and safety of the intervention | This outcome will be assessed using factors associated with lengths of stay less than or equal to 3 days. | Year 1 |
| Angers |
| France |
| CHU de Bordeaux | Bordeaux | France |
| CHU de Brest | Brest | France |
| CHU de Caen | Caen | France |
| Hôpital privé Saint Martin | Caen | France |
| CHU de Clermont-Ferrand | Clermont-Ferrand | France |
| Hôpital Henri Mondor (AP-HP) | Créteil | France |
| CHU de Dijon | Dijon | France |
| CHU de Grenoble | Grenoble | France |
| CHU de Limoges | Limoges | France |
| Hôpital privé Jacques Cartier | Massy | France |
| Clinique du Millénaire | Montpellier | France |
| Hôpital Bichat, AP-HP | Paris | France |
| Hôpital Européen Georges Pompidou (AP-HP) | Paris | France |
| CHU de Poitiers | Poitiers | France |
| CHU de Strasbourg | Strasbourg | France |
| CHU de Toulouse | Toulouse | France |
| Clinique Pasteur | Toulouse | France |
| Clinique Saint Gatien | Tours | France |
| ID | Term |
|---|---|
| D001024 | Aortic Valve Stenosis |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
| D006331 | Heart Diseases |
| D014694 | Ventricular Outflow Obstruction |
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