Same-Day Discharge After TAVR: Safe and Effective in Selected Patients
Same-Day Discharge After TAVR: Safe and Effective in Selected Patients
Source: Canadian Journal of Cardiology
Date: May 16 , 2025
The Canadian Journal of Cardiology (official journal of CCS) is now included in our academic exchange and collaboration framework with the Jordanian Cardiac Society (JCS).
Key Points:
1. Study Overview:
• Meta-analysis of over 35,000 patients from 6 studies.
• Compared same-day discharge (SDD) vs next-day discharge (NDD) after transfemoral TAVR.
2. Patient Profile:
• Mean age: 78.2 years.
• 59.3% male.
• 91.6% received balloon-expandable valves; only 8.4% self-expanding.
3. Outcomes After 30 Days:
• SDD linked to lower:
• Mortality.
• All-cause readmission.
• Cardiovascular readmission.
• Pacemaker implantation.
• Stroke and vascular complications: no significant difference vs NDD.
4. Why SDD Works:
• Stroke risk is highest in first 4–6 hours post-procedure, then declines.
• Advances in vascular closure devices improve safety.
5. Who qualifies for same-day discharge?
Selected patients for SDD are those who meet strict clinical criteria ensuring safety. These include conscious sedation, no procedural complications, stable vital signs and ECG within 4–6 hours, independent ambulation, sufficient home support, and proximity to the hospital. Patients must not have pre-existing conduction abnormalities or require a pacemaker. Most studies supporting SDD involved balloon-expandable valves, with limited data on self-expanding valves. Careful selection remains key.
6. Limitation:
• Lack of data on SDD with self-expanding valves.
• More research needed for this subgroup.
7. Conclusion:
• Same-day discharge is viable and safe for low-risk, elective transfemoral TAVR patients.
• Careful selection and follow-up remain essential.
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