Why the study?
Decreased length of stay is a trend after TAVR, but the feasibility and safety of next-day discharge in bicuspid aortic valve patients remained to be evaluated.
Does next-day discharge following TAVR have similar safety and readmission rates in bicuspid versus tricuspid aortic valve patients?
Does next-day discharge following TAVR have similar safety and readmission rates in bicuspid versus tricuspid aortic valve patients?
Next-day discharge after TAVR is feasible and safe in selected younger patients with bicuspid aortic valves, with 30-day outcomes comparable to those with tricuspid aortic valves.
NDD after TAVR may be feasible in selected BAV patients; leaves open need for randomized safety confirmation before practice change.
Background: Decreased length of stay in the index hospitalization is a tendency in transcatheter aortic valve replacement (TAVR) era. In this study, we aim to evaluate the feasibility and safety of next-day discharge (NDD) in bicuspid aortic valve (BAV) patients following TAVR. Methods: The study analyzed patients who received TAVR in 2019 to 2022. Thirty-day mortality and readmission rate were compared between BAV and tricuspid aortic valve (TAV) patients. Results: The proportion of NDD was similar between the BAV and TAV group (45.3 % vs 41.3 %, p = 0.487). In NDD patients, the lower age (72.0 [67.0, 77.0] yrs vs 74.0 [70.0, 80.0] yrs, p = 0.011) and STS score (2.33 [1.56, 3.54] % vs 3.82 [2.38, 5.70] %, p < 0.001) were observed in the BAV group. The NDD BAV patients had higher proportion of post-dilatation (74.3 % vs 50.7 %, p = 0.003) when compared with the TAV patients. The NDD patients was safe with no death both in BAV and TAV patients at 30-day follow-up. Moreover, the readmission rate was comparable between BAV and TAV patients who discharged on the next day after TAVR (8.1 % vs 14.0 %, p = 0.397). Conclusions: NDD after TAVR was feasible and safe in both BAV and TAV patients. The younger BAV patients with fast recovery deserve the next-day discharge after TAVR.
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Fan et al. (2022) studied this question.
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