Vol 25, No 1 (2018)
Original articles — Interventional cardiology
Published online: 2017-07-17

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Factors associated with safe early discharge after transcatheter aortic valve implantation

Omar Aldalati, Friedon Keshavarzi, Amit Kaura, Jonathan Byrne, Mehdi Eskandari, Ranjit Deshpande, Mark Monaghan, Olaf Wendler, Rafal Dworakowski, Philip MacCarthy
Pubmed: 28714522
Cardiol J 2018;25(1):14-23.

Abstract

Background: As transcatheter aortic valve implantation (TAVI) becomes more straightforward, a larger proportion of patients will be well enough to be discharged early. This study sought to charac­terise the clinical features that allowed patients to be discharged early after TAVI and to evaluate the safety of an early discharge policy.

Methods: All patients undergoing TAVI at the above cited center from August 2007 to March 2015 were included in this study. Baseline characteristics, in-hospital outcomes, re-admissions and mortality were compared.

Results: Three hundred thirty-seven TAVIs were performed during the study period, and 18 died in-hospital (18/337, 5.3%). Of the remaining patients, 56 were discharged within 3 days of the index procedure (‘early discharge group’ 56/319, 17.5%). There was no difference between the early discharge and late discharge group in terms of Valve Academic Research Consortium-2 (VARC-2) criteria out­comes, all-cause re-admission rates and the need for permanent pacemaker implantation. Mortality at 1 year was better among the early discharge group (3.6% vs. 15.6%, p = 0.014); a reflection of baseline clinical differences.

Conclusion: Early discharge of clinically selected TAVI patients is safe and appropriate. Lower logistic EuroSCORE, smaller delta creatinine and not developing any complications are factors associated with early discharge. (Cardiol J 2018; 25, 1: 14–23)

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