Safety of same‐day discharge after uncomplicated, minimalist transcatheter aortic valve replacement in the COVID‐19 era
- 31 December 2020
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 97 (5), 940-947
- https://doi.org/10.1002/ccd.29453
Abstract
Objectives We sought to evaluate the safety, efficacy and feasibility of same‐day discharge after uncomplicated, minimalist TAVR. Background At the start of the COVID‐19 pandemic, we created a same‐day discharge (SDD) pathway after conscious sedation, transfemoral (minimalist) TAVR to help minimize risk of viral transmission and conserve hospital resources. Studies support that next‐day discharge (NDD) for carefully selected patients following minimalist TAVR is safe and feasible. There is a paucity of data regarding the safety of SDD after TAVR. Methods In‐hospital and 30 day outcomes of consecutive patients meeting pre‐specified criteria for SDD after minimalist TAVR at our institution between March and July of 2020 were reviewed. Outcomes were compared to a NDD cohort from July 2018 through July 2020 that would have met SDD criteria. Primary endpoints were mortality, delayed pacemaker placement, stroke and cardiovascular readmission at 30 days. Results Twenty nine patients were discharged via the SDD pathway after TAVR. 128 prior NDD patients were identified who met all criteria for SDD. The STS scores were similar between the two groups (SDD 2.6% ±1.5 vs. NDD 2.3% ± 1.2). There were no deaths at 30 days in either group. There was no significant difference in delayed pacemaker placement (SDD 0% vs. NDD 0.8%, p > .99) or cardiovascular readmission (SDD 0% vs. NDD 5.5%, p = .35) at 30 days. Conclusions Same day discharge following uncomplicated, minimalist TAVR in selected patients appears to be safe, achieving similar 30 day outcomes as a cohort of next day discharge patients.Keywords
This publication has 27 references indexed in Scilit:
- Predictors and Clinical Outcomes of Next-Day Discharge After Minimalist Transfemoral Transcatheter Aortic Valve ReplacementКАРДИОЛОГИЯ УЗБЕКИСТАНА, 2018
- Corrigendum to: 2017 ESC/EACTS Guidelines for the management of valvular heart diseaseEuropean Heart Journal, 2017
- 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesCirculation, 2017
- Vancouver Transcatheter Aortic Valve Replacement Clinical PathwayCirculation: Cardiovascular Quality and Outcomes, 2016
- Comparison of Outcomes of Transfemoral Transcatheter Aortic Valve Implantation Using a Minimally Invasive Versus Conventional StrategyThe American Journal of Cardiology, 2015
- Same day discharge after transcatheter aortic valve replacement: Are we there yet?Catheterization and Cardiovascular Interventions, 2015
- 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial FibrillationJournal of the American College of Cardiology, 2014
- Comparison of Transfemoral Transcatheter Aortic Valve Replacement Performed in the Catheterization Laboratory (Minimalist Approach) Versus Hybrid Operating Room (Standard Approach)КАРДИОЛОГИЯ УЗБЕКИСТАНА, 2014
- Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2)European Journal of Cardio-Thoracic Surgery, 2012
- Updated Standardized Endpoint Definitions for Transcatheter Aortic Valve ImplantationJournal of the American College of Cardiology, 2012