Is next-day discharge after uncomplicated transcatheter aortic valve implantation the new standard of care?

The minimisation and simplification of transcatheter aortic valve implantation (TAVI) procedures have set the basis for the development of ad hoc, streamlined periprocedural pathways to improve patient management and to increase the sustainability of TAVI programmes over the past decade.

The North American Vancouver Multidisciplinary, Multimodality, but Minimalist Approach to Transfemoral Transcatheter Aortic Valve Replacement (3MTAVR) and the European Feasibility and Safety of Early Discharge after Transfemoral TAVI (FAST-TAVI) trials were the first to prospectively assess the feasibility of early discharge after transfemoral TAVI by applying specific clinical criteria12. Both studies considered patients receiving the balloon-expandable SAPIEN transcatheter heart valve (THV) platform (Edwards Lifesciences), which has been historically associated with lower rates of permanent pacemaker implantation (PPI) after the procedure compared to the self-expanding CoreValve/Evolut THV platform (Medtronic), and up to 80% of patients in the Vancouver 3MTAVR trial were discharged the day after the procedure.

More recently, the Project to Look for Early Discharge in Patients Undergoing TAVI With ACURATE (POLESTAR) trial assessed the feasibility of early discharge in TAVI patients receiving the self-expanding ACURATE neo THV platform (Boston...