Feasibility and safety of next-day discharge following transcatheter bicuspid aortic valve replacement

Int J Cardiol Heart Vasc. 2022 Aug 2:42:101101. doi: 10.1016/j.ijcha.2022.101101. eCollection 2022 Oct.

Abstract

Background: Decreased length of stay in the index hospitalization is a tendency in transcatheter aortic valve replacement (TAVR) era. In this study, we aim to evaluate the feasibility and safety of next-day discharge (NDD) in bicuspid aortic valve (BAV) patients following TAVR.

Methods: The study analyzed patients who received TAVR in 2019 to 2022. Thirty-day mortality and readmission rate were compared between BAV and tricuspid aortic valve (TAV) patients.

Results: The proportion of NDD was similar between the BAV and TAV group (45.3 % vs 41.3 %, p = 0.487). In NDD patients, the lower age (72.0 [67.0, 77.0] yrs vs 74.0 [70.0, 80.0] yrs, p = 0.011) and STS score (2.33 [1.56, 3.54] % vs 3.82 [2.38, 5.70] %, p < 0.001) were observed in the BAV group. The NDD BAV patients had higher proportion of post-dilatation (74.3 % vs 50.7 %, p = 0.003) when compared with the TAV patients. The NDD patients was safe with no death both in BAV and TAV patients at 30-day follow-up. Moreover, the readmission rate was comparable between BAV and TAV patients who discharged on the next day after TAVR (8.1 % vs 14.0 %, p = 0.397).

Conclusions: NDD after TAVR was feasible and safe in both BAV and TAV patients. The younger BAV patients with fast recovery deserve the next-day discharge after TAVR.

Keywords: Bicuspid aortic valve; Next-day discharge; Transcatheter aortic valve replacement.