Country situation - challenges
In France, the number of implanted valves for aortic stenosis increased constantly from 150 in 2006 to 5500 in 2014. However, when compared to other European countries like Switzerland or Germany, the percentage of implanted patients in France is relatively low. In the same way, the percutaneous treatment of mitral regurgitation is also low. One of the main obstacles to this is the limited number of reimbursed procedures in France.
Thanks to Valve for Life (VFL) initiative and financial support, two registries are being conducted in France in order to show the real number of patients requiring TAVI (RAC Registy) or mitral percutaneous treatment (Mitragister Registry) to the French Health Authority.
Expectations and Results
1. For TAVI, a prospective registry was conducted in 45 implanting centres in France in September and October 2016 gathering the relevant data for the patients hospitalized for aortic valve stenosis. Altogether, the data for 1 100 patients was registered during these two months. Baseline data and allocated treatment (surgery, TAVI or medical treatment) and 1 year survival rate were accordingly analysed.
To better explain TAVI indications, the VFL Initiative France organised various regional meetings between interventional cardiologists and general practitioners. In particular, these meetings were organised in the regions where the prospective registry demonstrated discrepancy between the number of aortic stenosis patients and the number of TAVI performed.
The data was presented at the French congresses, EuroPCR and ESC events as well as to the French authority and resulted in increase of the number of refuned valves from 7,500 to 20,000. The objectives are deemed to be accomplished and no more actions are envisaged.
2. For Mitral Regurgitation (MR), a prospective registry MITRAGISTER is being conducted in the implanting centres (Mitraclip, percutaneous valve implantation etc) from September 2016 to September 2018. It purpose is to show the real number of patients requiring percutaneous mitral treatment, in case of primary or secondary MR, to the French Health Authority. All consecutive patients with a percutaneous Mitral valve treatment with a clinical and echographic follow-up will be included at 6, 12 and 24 months.
Penetration of TAVI in France show that in 2018, an average of 193 TAVI per million inhabitants were performed.
Country Champion: Prof. Martine Gilard
Last update: November 2019