Did the COVID-19 Pandemic Just Turn TAVR Into an Outpatient Procedure?

Giri, Jay; Fiorilli, Paul N.

doi:10.1016/j.jcin.2022.02.004

JACC: Cardiovascular Interventions

2022

DOI: 10.1016/j.jcin.2022.02.004

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Did the COVID-19 Pandemic Just Turn TAVR Into an Outpatient Procedure?

Jay Giri¹,

Paul N. Fiorilli²

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Cited by 3 publications

(2 citation statements)

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“…32 Beyond these emerging issues, it is reasonable to conclude that LoS represents a crucial point of superiority of TAVI as compared with SAVR in patients with established indications: 5 this study confirms that a large proportion of AS patients can be safely discharged early after undergoing uncomplicated TAVI through transfemoral access without jeopardizing the effectiveness of the procedure. 13 Consistently with a growing amount of evidence, 12 these data, intriguingly leveraging on the strain imposed on healthcare systems by the pandemic, 33 may contribute to the development of protocols aimed at avoiding unnecessary use of hospital resources.…”

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confidence: 78%

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Transcatheter aortic valve implantation 20 years later: early discharge after transfemoral minimalist procedures as a proof of effectiveness

Andò

Santis

2022

Journal of Cardiovascular Medicine

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Aortic stenosis (AS) is the most frequent valvular heart disease in Western countries, as a consequence of the ageing population and of the growing prevalence of cardiovascular risk factors: 1 the incidence of AS in the elderly is estimated to be between 2 and 9% and the severity of AS increases with age, with one in eight people older than 75 years showing moderate to severe AS. 2 Historical data suggest poor survival in patients with symptomatic severe AS; after the onset of angina or syncope in patients with severe high-gradient AS, the average survival has been reported to be <2-3 years, while life expectation is 12-18 months in patients with AS and heart failure. 3,4 No medical treatment can change the natural history of AS and early valve intervention is recommended in all patients with symptomatic severe AS unless concomitant conditions exist that preclude at least 1-year survival. 5 In symptomatic patients, intervention is recommended for severe, high-gradient AS (mean gradient !40 mmHg, peak velocity !4.0 m/s and valve area 1.0 cm 2 or 0.6 cm 2 /m 2 ) or for severe low-flow (SVi 35 ml/m 2 ) low-gradient (<40 mmHg) AS with left ventricular dysfunction and evidence of contractile reserve. 5 In asymptomatic patients, intervention is recommended for severe AS and systolic left ventricular dysfunction of no other cause or when symptoms can be demonstrated on exercise testing. 5 In addition, development of symptoms in asymptomatic patients with severe AS can be predicted by older age, burden of risk factors for atherosclerosis, extent of valve calcification, peak jet velocity, comprehensive echocardiographic evaluation, and abnormal biomarker levels such as natriuretic peptides or cardiac troponins. 5

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confidence: 78%

“…Key factors to select patients for expedited discharge after self-expanding TAVI procedures (elaborated from12,33 ) …”

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confidence: 99%

Transcatheter aortic valve implantation 20 years later: early discharge after transfemoral minimalist procedures as a proof of effectiveness

Andò

Santis

2022

Journal of Cardiovascular Medicine

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Editorial: Non-elective inpatient transcatheter aortic valve replacement: Satisfactory outcomes with unacceptable cost

Rahman,

Khan,

Kaluski

2024

Cardiovascular Revascularization Medicine

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Same-Day Discharge After Elective Percutaneous Transcatheter Cardiovascular Interventions

Krishnaswamy

Isogai

Brilakis

et al. 2023

JACC: Cardiovascular Interventions

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Did the COVID-19 Pandemic Just Turn TAVR Into an Outpatient Procedure?

Cited by 3 publications

References 17 publications

Transcatheter aortic valve implantation 20 years later: early discharge after transfemoral minimalist procedures as a proof of effectiveness

Transcatheter aortic valve implantation 20 years later: early discharge after transfemoral minimalist procedures as a proof of effectiveness

Editorial: Non-elective inpatient transcatheter aortic valve replacement: Satisfactory outcomes with unacceptable cost

Same-Day Discharge After Elective Percutaneous Transcatheter Cardiovascular Interventions

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