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Reducing length of stay after transfemoral transcatheter aortic valve implantation: the FAST-TAVI II trial.
Durand, Eric; Beziau-Gasnier, Delphine; Michel, Morgane; Iung, Bernard; Tchetche, Didier; Bonnet, Guillaume; Lhermusier, Thibault; Gilard, Martine; Souteyrand, Geraud; Bouleti, Claire; Ohlmann, Patrick; Lefevre, Thierry; Beygui, Farzin; Chassaing, Stephan; Chevreul, Karine; Eltchaninoff, Hélène.
Afiliación
  • Durand E; Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France.
  • Beziau-Gasnier D; Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France.
  • Michel M; Université Paris Cité, Paris, France.
  • Iung B; Inserm, ECEVE, Paris, France.
  • Tchetche D; Clinical Epidemiology Unit, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • Bonnet G; Cardiology Department, Bichat-Claude-Bernard Hospital Cardiology Service, Paris, France.
  • Lhermusier T; Clinique Pasteur, Toulouse, France.
  • Gilard M; Unité médico-chirurgicale des valvulopathies, CHU de Bordeaux, 33600 Pessac, France.
  • Souteyrand G; CHU de Toulouse, Pôle Cardiovasculaire et Métabolique, Toulouse, France.
  • Bouleti C; Department of Cardiology, CHRU Brest, 29200 Brest, France.
  • Ohlmann P; CHU de Clermont-Ferrand, Clermont-Ferrand, France.
  • Lefevre T; Clinical Investigation Center (INSERM 1204), Cardiology Department, ACTION and FACT study groups, University of Poitiers, Poitiers Hospital, France.
  • Beygui F; Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France.
  • Chassaing S; Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Générale de santé, Massy, France.
  • Chevreul K; Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France.
  • Eltchaninoff H; Cardiology Department, Clinique NCT+-Saint Gatien-Alliance, Tours, France.
Eur Heart J ; 45(11): 952-962, 2024 Mar 14.
Article en En | MEDLINE | ID: mdl-38437633
ABSTRACT
BACKGROUND AND

AIMS:

The length of stay (LOS) after transcatheter aortic valve implantation (TAVI) remains extremely variable whereas early discharge has been shown to be feasible and safe. The study objective was to evaluate the efficacy and safety of an intervention aimed at reducing LOS after transfemoral TAVI.

METHODS:

FAST-TAVI II is a prospective, multicentre, cluster, randomized, controlled study including patients with severe symptomatic aortic stenosis, who had transfemoral TAVI. The intervention consisted in a dedicated training programme to implement 10 quality of care measures to reduce LOS with an implementation phase of eight weeks. The primary endpoint was the proportion of patients discharged early within 3 days. Secondary endpoints included LOS, 30-day mortality and 30-day incidence of readmission for cardiovascular events.

RESULTS:

During the study period, 969 patients were enrolled in the intervention group and 860 patients in the control group. Mean age was 81.9 ± 6.6 years and mean EuroSCORE II was 4.4 ± 4.5%. Early discharge was achieved in 563 (58.1%) patients in the intervention group vs. 364 (42.3%) patients in the control group (P < .0001). Median LOS was significantly reduced in the intervention group compared to the control group [3 (IQR 3) vs. 4 days (IQR 3), P < .0001]. Thirty-day mortality was low and similar in the two groups (0.5% vs. 0.9%, P = .30), as were 30-day readmissions (4.6% vs. 2.8%, P = .28).

CONCLUSIONS:

The intervention was simple and fast to implement, and was effective and safe to reduce LOS and increase the proportion of patients discharged early after TAVI (NCT04503655).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Humans Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Humans Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido