Background: Currently, there are no recommendations regarding the minimum duration of in-hospital 4 monitoring after transfemoral (TF) transcatheter aortic valve replacement (TAVR) and practices are extremely 5 heterogeneous. We therefore aimed to evaluate length of stay (LOS) and predictive factors for late discharge 6 after TF TAVR using data from the FRANCE TAVI registry.
7Methods: TAVR was performed in 12,804 patients in French centers between and 2015. LOS was evaluated in 5,857 TF patients discharged home. LOS was calculated from TAVR procedure (day 0) to 9 discharge. The study population was divided into 3 groups based on LOS values. Patients discharged within 3 10 days constituted the "very early" discharge group, patients with a LOS between 3 and 6 days constituted the 11 "early" discharge group, and patients with a length of stay >6 days constituted the "late" discharge group.12 Results: The median LOS was 7 (5-9) days and was extremely variable among centers. The proportion of 13 patients discharged very early, early, and late was 4.4% (n=256), 33.7% (n=1997), and 61.9% (n=3624) 14 respectively. Variables associated with late discharge were female sex, co-morbidities, major complications, self 15 expandable valve, general anesthesia, and a significant center effect. In contrast, history of previous pacemaker 16 was a protective factor. The composite of death and re-admission in the very early and early versus late 17 discharge groups were similar at 30 days (3.3% vs. 3.5%, p=0.66).
18Conclusions: LOS is extremely variable after TF TAVR in France. Co-morbidities and complications were 19 predictive factors of late discharge after TAVI. Interestingly, the use of self-expandable prosthesis and general 20 anesthesia may also contribute to late discharge. Our results confirm that early discharge is safe.