Author + information
- Received April 9, 2018
- Revision received June 14, 2018
- Accepted June 26, 2018
- Published online November 5, 2018.
- Marco Spaziano, MD, MSca,b,
- Thierry Lefèvre, MDa,∗ (, )
- Mauro Romano, MDa,
- Helene Eltchaninoff, MD, PhDc,
- Pascal Leprince, MD, PhDd,
- Pascal Motreff, MD, PhDe,
- Bernard Iung, MDf,
- Eric Van Belle, MD, PhDg,
- René Koning, MDh,
- Jean Philippe Verhoye, MD, PhDi,
- Martine Gilard, MD, PhDj,
- Philippe Garot, MDa,
- Thomas Hovasse, MDa,
- Hervé Le Breton, MD, PhDk and
- Bernard Chevalier, MDa
- aParis South Cardiovascular Institute, Jacques-Cartier Private Hospital, Ramsay Générale de Santé, Massy, France
- bMcGill University Health Centre, Royal-Victoria Hospital, Montréal, Canada
- cCardiology Service, Rouen–Charles-Nicolle University Hospital Center, National Institute of Health and Medical Research U644, Rouen, France
- dSorbonne–Pierre-et-Marie-Curie University, Public Assistance Hospitals of Paris, Groupe Hospitalier de la Pitié Salpêtrière, Cardiac Surgery, Paris, France
- eDepartment of Cardiology, Gabriel Montpied University Hospital Center, Image Science for Interventional Techniques, Cardiovascular Interventional Therapy and Imaging, National Scientific Research Center Unité Mixte de Recherche (UMR) 6284, University of the Auvergne, Clermont-Ferrand, France
- fDepartment of Cardiology, Bichat Hospital, APHP, DHU Fire and Paris-Diderot University, Paris, France
- gDepartment of Cardiology, University of Lille 2, Regional University Hospital Center of Lille, National Institute of Health and Medical Research U1011, University Hospital Federation Integra, Lille, France
- hCardiology Service, Saint Hilaire Clinic, Rouen, France
- iThoracic and Cardiovascular Surgery Service, Pontchaillou University Hospital Center, University of Rennes 1, Signal and Image Treatment Laboratory, National Institute of Health and Medical Research U1099, Rennes, France
- jLa Cavale Blanche University Hospital Center, Optimization of Physiological Regulations, Science and Technical Training and Research Unit, University of Western Brittany, Brest, France
- kCardiology and Vascular Diseases Service, Pontchaillou University Hospital Center, Center for Clinical Investigation 804, University of Rennes 1, Signal and Image Treatment Laboratory, National Institute of Health and Medical Research U1099, Rennes, France
- ↵∗Address for correspondence:
Dr. Thierry Lefèvre, Service Angio, Hopital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300, Massy, France.
Objectives This study sought to compare outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) in a catheterization laboratory (cath lab) to those undergoing TAVR in a hybrid operating room (OR).
Background TAVR can be performed in a cath lab or in a hybrid OR. Comparisons between these locations are scarce.
Methods All TAVRs performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) registry. The primary endpoint of this study was all-cause mortality at 1 year. Secondary endpoints consisted of 30-day complications and 3-year mortality. All analyses were adjusted for baseline and procedural characteristics.
Results A total of 12,121 patients were included in this study, 62% of which underwent TAVR in a cath lab versus 38% in a hybrid OR. Mean age was 82.9 ± 7.2 years, 48.9% of patients were men, and mean Logistic EuroScore was 17.9% ± 12.3%. Both procedure locations showed similar, below 2% rates of intraprocedural complications. After adjusting for baseline and procedural characteristics, major bleeding and infections were significantly higher in the hybrid OR group (bleeding, 6.3% vs. 4.8%; infection, 6.1% vs. 3.5%; p < 0.05). Adjusted mortality rates at 1 and 3 years did not differ significantly between groups (for cath lab vs. hybrid OR, respectively: 1 year: 16.2% vs. 15.8%; p = 0.91; 3 years: 38.4% vs. 36.4%; p = 0.49).
Conclusions Midterm mortality after TAVR was similar between the cath lab and the hybrid OR. These findings support the performance of TAVR in either location, which has important implications on health care organization and costs.
- catheterization laboratory
- hybrid operating room
- procedure location
- transcatheter aortic valve replacement
Dr. Lefèvre has served as a proctor for Edwards Lifesciences and Abbott; and received lecture fees from Edwards Lifesciences and Abbott. Dr. Romano is a consultant and proctor for Edwards Lifesciences; and received modest speaker honoraria from Edwards Lifesciences. Dr. Eltchaninoff has served as a proctor for and received lecture fees from Edwards Lifesciences. Dr. Leprince has served as a proctor for Medtronic; and a speaker for Edwards Lifesciences. Dr. Iung has received consulting fees from Edwards Lifesciences; and received a speaker fee from Novartis and Boehringer Ingelheim. Dr. Koning has clinical research relationships with Boehringer Ingelheim, Boston Scientific, Abbott, Biosensor, and Biotronik. Dr. Le Breton has received speaker fees from Edwards Lifesciences and Medtronic. Dr. Chevalier has served as a consultant and proctor for Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 9, 2018.
- Revision received June 14, 2018.
- Accepted June 26, 2018.
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