December 31, 2020Catheterization and Cardiovascular Interventions
Safety of same‐day discharge after uncomplicated, minimalist transcatheter aortic valve replacement in the COVID‐19 era
Key result
Same-day discharge after uncomplicated, minimalist TAVR was safe, with no 30-day mortality and similar rates of cardiovascular readmission (0% vs 5.5%, P=0.35) compared to next-day discharge.
Why the study?
While next-day discharge following minimalist TAVR is safe and feasible, there is a paucity of data regarding the safety, efficacy, and feasibility of same-day discharge.
Does a same-day discharge pathway maintain safety and efficacy compared to next-day discharge in selected patients undergoing uncomplicated, minimalist TAVR?
Population
Twenty nine SDD patients and 128 NDD patients meeting pre-specified SDD criteria after minimalist TAVR
Comparison
Same-day discharge pathway vs next-day discharge
Design
Single-center observational cohort study
Follow-up
30 days
Authors
Discussion
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Implication
May support SDD after selected minimalist TAVR; hypothesis-generating and requires randomized trials before practice change.
Study Design
Type
Cohort (n=157)
Multicenter
No
Structured PICO
Does a same-day discharge pathway maintain safety and efficacy compared to next-day discharge in selected patients undergoing uncomplicated, minimalist TAVR?
P
Population
157 patients undergoing uncomplicated, minimalist TAVR who met criteria for same-day discharge, followed for 30 days.
E
Exposure
Same-day discharge (SDD) pathway
C
Comparator
Next-day discharge (NDD) pathway (historical cohort from July 2018 through July 2020 meeting SDD criteria)
O
Outcome
Mortality, delayed pacemaker placement, stroke and cardiovascular readmission at 30 dayssafety
Main Result
Absolute Event Rate: 0% vs 5.5%
p-value: p=0.35
Same-day discharge following uncomplicated, minimalist TAVR in carefully selected patients appears safe and feasible, yielding similar 30-day outcomes to next-day discharge.
Cite This Study
Perdoncin et al. (2020) conducted a cohort in Uncomplicated, minimalist TAVR (n=157). Same-day discharge vs. Next-day discharge was evaluated on Cardiovascular readmission at 30 days (p=0.35). Same-day discharge after uncomplicated, minimalist TAVR was safe, with no 30-day mortality and similar rates of cardiovascular readmission (0% vs 5.5%, P=0.35) compared to next-day discharge.