# Safety of Same-Day Discharge After Elective Transcatheter Aortic Valve Implantation With Balloon- and Self-Expanding Valves: A Prospective Single-Center UK Study

## TL;DR

The study shows that same-day discharge after aortic valve implantation is safe for selected patients, with no increased risk of complications.

## Contribution

Demonstrates the safety of same-day discharge for TAVI patients using both balloon- and self-expanding valves.

## Key findings

- Same-day discharge had no significant difference in 30-day complications compared to non-SDD patients.
- Patients with self-expanding valves had similar outcomes to those with balloon-expandable valves.
- No increased risk of 30-day pacemaker implantation was observed in SDD patients.

## Abstract

In patients undergoing transcatheter aortic valve implantation (TAVI), it is unclear whether same-day discharge (SDD) while adopting a device-agnostic approach is a safe strategy compared to non-SDD. We aim to compare TAVI patients who underwent SDD and non-SDD according to a predefined protocol.

This is a prospective single-center study of consecutive patients who were scheduled for elective TAVI procedures. The primary endpoint was the composite of death, vascular access–related complications, any bleeding requiring hospitalization, all stroke (or transient ischemic attack), or new permanent pacemaker implantation at 30 days defined according to the Valve Academic Research Consortium 3 criteria.

Out of 472 consecutive patients who underwent elective TAVI, 289 patients did not report procedural complications, of whom 60 (21%) were discharged on the same day. The mean age was 81 ± 7 years, with 60% of the cohort being male. There were no significant differences in clinical characteristics among patients according to their in-hospital SDD strategy. Pre-existing left or right bundle branch block was comparable between the 2 groups. The primary endpoint was reported in 2.8% of the entire cohort, with no significant difference between patients who underwent SDD TAVI and those who did not (1.7% vs. 3.1%, respectively, p = 0.56). Patients who had a self-expanding valve had a comparable primary endpoint to those who had a balloon-expandable valve, including readmission for a permanent pacemaker.

SDD TAVI is a safe and feasible approach in patients who underwent an elective uneventful procedure, including patients who received self-expanding valves. Future studies are required to support these findings.

Summary of clinical outcomes of patients undergoing same-day versus non–same-day discharge: Patients who met inclusion criteria for same-day discharge were compared with those who stayed in hospital for at least one night, and outcomes, including death, vascular complications, neurological events, and late pacemaker, were assessed at 30 days.

•Same-day discharge following elective trans-catheter aortic valve implantation appears safe for a selected group of patients.•Same-day discharge was not associated with increased risk of 30-day pacemakers.

Same-day discharge following elective trans-catheter aortic valve implantation appears safe for a selected group of patients.

Same-day discharge was not associated with increased risk of 30-day pacemakers.