Key result
Same-day discharge after transcatheter aortic valve replacement is a safe and feasible option for carefully selected patients, reducing hospital length of stay without increasing complications.
Why the study?
Following the COVID-19 pandemic and initial reports of same-day discharge after TAVR, several institutions modified discharge protocols, prompting an evaluation of the safety, feasibility, and efficiency of this approach across healthcare systems.
Does same-day discharge after TAVR maintain safety and feasibility compared to next-day discharge in carefully selected patients with severe aortic stenosis?
Does same-day discharge after TAVR maintain safety and feasibility compared to next-day discharge in carefully selected patients with severe aortic stenosis?
Same-day discharge after uncomplicated, minimalist TAVR is safe and feasible in carefully selected patients, optimizing hospital resource utilization without compromising 30-day clinical outcomes.
Supports feasibility of same-day TAVR discharge in selected patients; leaves open randomized confirmation before practice change.
Transcatheter aortic valve replacement (TAVR) has been established as an alternative to surgical aortic valve replacement in select patients with severe aortic stenosis. Next-day discharge (NDD) after TAVR allow patients rapid mobilisation to return home. A minimalist pathway using NDD has been shown to be effective and safe in carefully selected patients. Following the COVID-19 pandemic and earlier reports of same-day discharge (SDD) after TAVR, in 2020 several institutions modified NDD protocols to carefully select patients for discharge the same day. These protocols maximised efficiency and resource utilisation while minimising COVID-19 exposures, hospital length of stay, and healthcare-associated costs, both to the institution and to the patient. In this literature review, the authors discuss the precedent for SDD after TAVR, investigate the pressure for efficiency amidst a global pandemic, and assess the safety and feasibility of SDD as seen across multiple healthcare systems.
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D’Orleans et al. (2022) conducted a review in Severe aortic stenosis. Same-day discharge after TAVR vs. Next-day discharge or standard care was evaluated. Same-day discharge after transcatheter aortic valve replacement is a safe and feasible option for carefully selected patients, reducing hospital length of stay without increasing complications.
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