The following is a summary of “Safety and feasibility of early discharge after transcatheter aortic valve implantation with ACURATE Neo—the POLESTAR trial,” published in the April 2024 issue of Cardiology by Ooms et al.
Transcatheter aortic valve implantation (TAVI) is standard in people with severe aortic stenosis (AS). The evolution in treatment procedures has significantly minimized the length of hospital stays.
Researchers conducted a prospective study evaluating the safety and efficacy of an early discharge (ED) strategy after TAVI.
They used an international, multi-center prospective study in patients with AS undergoing TAVI with the ACURATE valve platform. Patients’ eligibility was checked for ED before TAVI, following specific criteria. Discharge between 0 and 48 h was defined as ED. Primary Valve Academic Research Consortium (VARC)-3-defined 30-day safety and efficacy composite endpoints were marked at 48 h and compared between ED and non-ED groups.
The results showed 252 patients, mostly around 82 (25th-75th percentile, 78-85) years old with low median surgical risk according to the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score (2.2%, 1.6-3.3). ED was achieved in 173 (69%), and non-ED patients were 79 (31%) in number, with monitoring for conduction disturbances being the main reason for non-ED. At 30 days, 1% had died, 4% got new pacemakers, and 4% were readmitted, with no difference in safety and efficacy between ED and non-ED groups (OR 0.84 [25th-75th percentile, 0.31-2.26], P=0.73 and OR 0.97 [25th-75th percentile, 0.46-2.06], P=0.94).
Investigators concluded that ED after TAVI with ACURATE valve is safe and feasible for certain patients. However, Rhythm monitoring and extended clinical observation might increase their hospital stay.
Source: link.springer.com/article/10.1007/s00392-024-02436-z
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