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Contribution of cardiac surgeons in transcatheter aortic valve replacement activity in France
Gabriel Saiydoun1,2, Saadé Saadé3, Chadi Aludaat4
1Department of Cardiac Surgery, Pitié Salpetrière University Hospital, Sorbonne University, Paris, France.
Objectives:
This study provides a thorough analysis of cardiac surgeons' involvement in transcatheter aortic valve replacement (TAVR) activities in France, covering decision-making, procedural roles, training and outcome analysis.
Methods:
A nationwide survey was sent to all cardiac surgeons and all cardiac surgery trainees in France. Subgroup analysis was performed for age, status (established versus in-training) and type of practice facility.
Results:
A total of 172 surgeons from both private and public sectors responded to the survey. Most respondents (71%) had TAVR activity, and there were no significant differences between subgroups. Most respondents with TAVR activities (30%) had average access (once per week). Almost one-third of centres had >3 established surgeons with TAVR activity, whereas 19% had no in-training surgeons with TAVR activity. TAVR was the only structural practice for 67% of surgeons, while 33% practiced other structural procedures. When asked, 82% of surgeons were against establishing TAVR programmes in centres without a cardiac surgery programme. Most TAVR patients (72%) were discussed by the Heart Team, and only 9% of surgeons said their relationship with the interventional cardiologist was disrupted. Two-thirds of vascular complications were managed by cardiac surgery, and only 6% of cardiac surgeons admitted were unfit to handle any vascular complications.
Conclusions:
In France, cardiac surgeons are becoming increasingly involved in TAVR procedures as an integral part of the Heart Team.
