The challenge of early discharge after transcatheter aortic valve implantation

Thanks to next-generation transcatheter valves, physician experience and treatment of lower risk patients, complications after transcatheter aortic valve implantation (TAVI) have continuously declined. In parallel, the increasing number of procedures performed has placed a significant strain on hospital resources and may hamper access for those in need1. In some centres, the waiting list for TAVI extends beyond 1 year. Evidence clearly indicates that such a long waiting time is associated with patient morbidity and mortality2. To mitigate these shortcomings, efforts have been made to shorten the duration of hospitalisation after TAVI.

In this issue of EuroIntervention, Bendandi et al present the D-PACE score which may help to identify candidates for early (same day or next-day) discharge after TAVI3. The score identifies the risk for delayed high-degree atrioventricular (AV) blocks, the major concern when discharging patients early after TAVI. The score incorporates data from pre- and next-day electrocardiograms, the type of valve used, and the implantation depth. Around 40% of patients were identified to be at very low risk for delayed high-degree AV block, and thus were candidates for...