Subject(s)
Clinical Decision-Making , Eligibility Determination/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Medicare/legislation & jurisprudence , Patient Selection , Transcatheter Aortic Valve Replacement/legislation & jurisprudence , Consensus , Fee-for-Service Plans/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Health Services Needs and Demand/legislation & jurisprudence , Humans , Policy Making , United StatesABSTRACT
Well conditions to perform TAVI procedures are guided by ministry regulation and dedicated to centers with both on-site a cath-lab and cardiac surgery. Heart Team decision is mandatory to select patient for TAVI and local anesthesia is recommended. Conditions changes would be discuss according to increased procedures number related to indications evolution.
Subject(s)
Cardiology Service, Hospital/organization & administration , Patient Care Team/organization & administration , Patient Selection , Transcatheter Aortic Valve Replacement , Anesthesia, Local , France , Hospital Mortality , Humans , Operating Rooms/organization & administration , Practice Guidelines as Topic , Preoperative Care/legislation & jurisprudence , Preoperative Care/methods , Transcatheter Aortic Valve Replacement/legislation & jurisprudence , Transcatheter Aortic Valve Replacement/methods , Transcatheter Aortic Valve Replacement/mortalityABSTRACT
Compassionally reserved for inoperable patients in 2002, Transcatheter Aortic Valve Implantation has now a place almost equivalent to surgical valve replacement. The pioneering teams first succeeded in demonstrating a benefit on the mortality of extremely serious patients, while managing a learning curve that seemed unreachable without a strong partnership with cardiac surgeons. This win/win challenge enabled cardiologists to surpass the limits they did not dare to brave (management of large arterial approach, annular rupture and tamponade) and surgeons to appropriate the endovascular's culture. The technological contribution, the maturity of the teams and the expansion to less severe populations have reduced the perioperative mortality of TAVI to less than 3%. At this stage, it seemed interesting to take stock of forensic developments around this technique. After a review of the studies and the healthcare requirements, we reported and analyzed the claims received from one of the leaders of the medical insurance in France. From this feedback, attempts will be made to identify ways of improving the prevention and subsequent treatment of complications, which will undoubtedly limit the risk of subsequent complaints.
