- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02956915
Evaluation of Length of Stay After TF-TAVI (FAST-TAVI)
Evaluation of Length of Stay and Predisposing Factors of Late Discharge After Transfemoral Transcatheter Aortic Valve Implantation Using the SAPIEN-3 Prosthesis: A French Multicenter Prospective Observational Trial
Transcatheter aortic valve implantation (TAVI) has been rapidly adopted worldwide since the first-in-man TAVI performed in 2002. With increasing experience and improvements in valve design, the "minimalist" approach to transfemoral TAVI (using local anesthesia and fluoroscopic guidance) has become an attractive concept, and the technical feasibility of this approach has been well documented.
While earlier data showed prolonged length of stay after TF-TAVI [10.5 ± 8.1 days in the FRANCE 2 registry and 10.2 ± 11.1 days in the PARTNER Cohort A data, the UK TAVI registry (reference) showed a decline in post-TAVI length of stay from 10 days to 8 days over the time period of 2007 to 2012. More contemporary data from other centers has been published showing that 23% of TF-TAVI patients were discharged within 3 days after TAVI. With an increasingly minimalist approach to TF-TAVI, the duration of monitoring required post-procedure remains indeterminate with a lack of formal consensus.
Early discharge (within 3 days of TAVI) is hypothesized to have multiple potential advantages, including reduction in unnecessarily lengthy hospitalization of frail and elderly patients in addition to cost-saving benefits. Rouen University Hospital has previously published a retrospective study on the feasibility and safety of early discharge, in which discharge within 72 hours of uncomplicated TF-TAVI was safe and attained in 36% of our patients. Pre-existing pacemaker and the absence of acute kidney injury were independent predictors of a successful early discharge. Moreover, in a prospective study, Rouen University Hospital recently shown that early discharge afterelective TF-TAVI with SAPIEN-XT/SAPIEN-3 prostheses was attainable in a large proportion of patients (59%) with no evident compromise in safety. Factors associated with failure of early discharge were postprocedural blood transfusion and permanent pacemaker implantation. But currently, there are no guidelines for the length of stay after a TF-TAVI.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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-
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Brest, France
- Brest University Hospital
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Massy, France
- Jacques CARTIER Private Hospital
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Paris, France
- AP-HP Bichat - Claude Bernard Hospital
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Rennes, France
- Rennes University Hospital
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Rouen, France
- ROUEN university hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Stable patients with severe symptomatic aortic stenosis
- Patient undergoing planned TF-TAVI with the SAPIEN-3 prosthesis,
- TF-TAVI using a minimalist approach of local anesthesia and conscious sedation
Exclusion Criteria:
- The use of other (than Edwards SAPIEN-3 or XT) transcatheter aortic valve devices.
- TF-TAVI requiring general anesthesia or surgical cut-down.
- TF-TAVI performed in unstable patients or on an urgent/emergent basis.
- Non-transfemoral routes of valve delivery (eg. transapical, transaortic, etc).
- Discharge back home impossible (including transfer in another hospital)
- Programmed transfer to another hospital
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
patients with severe symptomatic aortic stenosis
Stable patients with severe symptomatic aortic stenosis undergoing planned Transfemoral Transcatheter aortic valve implantation with the SAPIEN-3 prosthesis will be included.
TF-TAVI will be done using a minimalist approach of local anesthesia and conscious sedation.
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Transcatheter aortic valve implantation (TAVI): The SAPIEN-3 prosthese are implanted without open heart surgery.
The valve delivery system is inserted in the body via the femoral artery.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Evaluation of length of stay and reasons for prolonged hospitalization beyond 3 days
Time Frame: 30 days after TF TAVI procedure
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30 days after TF TAVI procedure
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of early discharge/prolonged hospitalization in the overall study population
Time Frame: 30 days after TF TAVI procedure
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Length of stay will be calculated from TAVI procedure (day 0) to discharge
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30 days after TF TAVI procedure
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Safety of early discharge
Time Frame: 30 days after TF TAVI procedure
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Combined endpoint of mortality or rehospitalization at 30-days after TF-TAVI procedure
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30 days after TF TAVI procedure
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Predictors of early discharge success or failure by multivariate analysis
Time Frame: 30 days after TF TAVI procedure
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30 days after TF TAVI procedure
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2016/012/HP
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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