Same-Day Discharge After Elective Percutaneous Transcatheter Cardiovascular Interventions

Krishnaswamy, Amar; Isogai, Toshiaki; Brilakis, Emmanouil S.; Nanjundappa, Aravinda; Ziada, Khaled M.; Parikh, Sahil A.; Rodés‐Cabau, Josep; Windecker, Stephan; Kapadia, Samir

doi:10.1016/j.jcin.2023.05.015

Cited by 3 publications

(1 citation statement)

References 97 publications

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“…However, patients are increasingly being discharged within 24–48 h after TAVR, and some experts have even advocated same-day discharge in carefully selected patients. 17 , 18 Currently, the temporary pacing methods used during the perioperative period of TAVR are not suitable for discharged patients and are associated with a higher risk of infection, venous thrombosis, prolonged hospitalization, and delayed rehabilitation; patients should be bedridden until the pacing lead is removed to avoid dislodgement. 19 Accordingly, strategies that offer pacing protection, improve mobility, shorten hospital stay, and reduce the PPM implantation rate are vital to advancing TAVR and preventing cardiac arrest events in outpatients, which can result in sudden death.…”

Section: Discussionmentioning

confidence: 99%

Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

Chang,

Jiang,

Liu

et al. 2024

eClinicalMedicine

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Section: Discussionmentioning

confidence: 99%

Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

Chang,

Jiang,

Liu

et al. 2024

eClinicalMedicine

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Impact of a dedicated radial lounge on same‐day discharge percutaneous coronary intervention

Liberman,

Botto,

Benzadon

et al. 2024

Cathet Cardio Intervent

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BackgroundThe same‐day discharge (SDD) program after elective percutaneous coronary intervention (PCI) is a safe strategy that allows for the optimization of hospital resources. However, the lack of adequate infrastructure and a specially targeted care model may limit its implementation. Our center developed an outpatient care model based on an area designed for percutaneous procedures called radial lounge (RL).AimsEvaluate the efficacy and safety of the RL care model: (1) SDD rate, (2) patient experience, (3) major adverse cardiac events (MACEs) (in‐hospital, 30‐day, and 1‐year mortality and intervention), and (4) vascular access complication. Secondary objective: Impact of RL SDD rate on total elective SDD‐PCI volume.MethodsWe conducted a retrospective observational cohort study at a cardiovascular hospital, including consecutive patients undergoing elective PCI between 2015 and 2022 who were admitted to the conventional hospitalization area (CHA) or the RL about the stated objectives. Patient experience was assessed using the Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.ResultsA total of 5466 elective PCI procedures were included: 2102 in the RL and 3364 in the CHA. The SDD rate was 85.2% in the RL group and 54% in the CHA. After the implementation of RL, a significant increase in the volume of elective SDD‐PCI was observed and patient satisfaction improved significantly (p < 0.005) with CHA. Finally, a greater amount of MACEs were not observed in the RL.ConclusionsThe PCI program in RL proved to be safe and effective. It showed a higher rate of SDD and a significant improvement in patient experience was observed without affecting safety.

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Same‐Day Discharge After Uncomplicated Transcatheter Tricuspid Valve‐In‐Valve Implantation

Chan,

Anderson,

Hagler

et al. 2024

Cathet Cardio Intervent

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BackgroundTricuspid valve‐in‐valve (TVIV) implantation has traditionally included post‐procedure overnight in‐hospital observation with next‐day discharge. Recently, our practice has shifted toward same‐day discharge for most patients after vascular access site hemostasis and adequate recovery from anesthesia. However, data on the safety of this approach remains scarce.AimsOur study aims to describe our practice change and to identify factors that may lead to overnight observation post‐TVIV.MethodsWe retrospectively reviewed medical records of patients who underwent uncomplicated TVIV implantation as an outpatient procedure at Mayo Clinic between 2011 and 2023.ResultsOf the 83 patients who underwent TVIV from 2011 to 2023, 65 (78%) were included in the study. The first 39 patients in our institutional series were observed overnight as standard practice. 18 (69%) of the most recent 26 patients in our series were discharged the same day; three patients who remained in the hospital overnight were because of provider preference and/or patient preference without any specific medical concern. Of all 47 patients who were observed overnight, one patient was treated for fluid overload, one patient had non‐sustained ventricular tachycardia on telemetry that resulted in adjustment of antiarrhythmic therapy, two patients had continued bleeding from the access sites and was observed for another day. Among the two of them, one also developed atrial tachyarrhythmias requiring initiation of additional antiarrhythmic therapy. Out of 18 patients discharged the same day, one patient had an ED presentation within 24 h due to access site bleeding which was resolved promptly. There was no mortality or procedural‐related readmission.ConclusionSame‐day discharge may be considered for adult patients who have undergone uncomplicated TVIV with adequate hemostasis and recovery after anesthesia.

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Same-Day Discharge After Elective Percutaneous Transcatheter Cardiovascular Interventions

Cited by 3 publications

References 97 publications

Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

Impact of a dedicated radial lounge on same‐day discharge percutaneous coronary intervention

Same‐Day Discharge After Uncomplicated Transcatheter Tricuspid Valve‐In‐Valve Implantation

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