Background
Next-day discharge after transcatheter aortic valve replacement (TAVR) is the preferred standard at many institutions in the United States. Studies show that outcomes are better in patients discharged early rather than late. The coronavirus disease 2019 (COVID-19) pandemic led to the cancellation of elective and nonurgent procedures throughout the United States. To mitigate the clinical, social, and economic impact of procedure cancellations on patients and the health care institution, our structural heart team decided to implement a strategy of same-day discharge (SDD) after TAVR if safety criteria (Figure 1) were met.
Methods
This was a single-center case series of consecutive patients who underwent SDD after self-expanding valve TAVR at our institution. If patients met preset safety criteria (Figure 1), they were discharged on the day of the procedure with next-day follow-up at the clinic.
Results
A total of 36 TAVRs were performed at our institution over a 1-year period during the COVID-19 pandemic. Nine patients (25%) were discharged on the same day, as they met the SDD safety criteria. Seven of 9 of these patients underwent self-expanding valve, minimalist TAVR. There were no hospital readmissions, need for new permanent pacemaker, or deaths at 30-day follow-up. No delayed complications occurred in the patients who underwent SDD after minimalist, self-expanding valve TAVR.
Conclusion
In selected patients, SDD following uncomplicated, minimalist TAVR using a self-expanding valve is safe and feasible.
Categories
STRUCTURAL: Valvular Disease: Aortic