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Updated: Mar 15, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Influence of same-day admission on outcomes following transcatheter aortic valve replacement
Samir V Patel1, Sunny Jhamnani2, Palak Patel1
1Department of Internal Medicine, Western Reserve Health Education, Youngstown, Ohio.
Insights
Performing elective transcatheter aortic valve replacement (TAVR) on the same day of admission (Day 0) significantly reduces hospitalization costs and length of stay compared to the next day (Day 1), with similar safety outcomes.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Economics
Background:
- Elective transcatheter aortic valve replacement (TAVR) can be scheduled for the day of admission (Day 0) or the day after (Day 1).
- The optimal timing for elective TAVR relative to admission day remains an area for investigation.
Purpose of the Study:
- To compare the economic and clinical outcomes of elective TAVR performed on Day 0 versus Day 1.
- To determine if same-day admission TAVR offers advantages over next-day admission TAVR.
Main Methods:
- Retrospective cohort study using the 2012 Nationwide Inpatient Sample database.
- Identified 843 endovascular TAVRs (ICD-9-CM code 35.05).
- Compared hospitalization costs, length of stay, in-hospital mortality, and complication rates between Day 0 and Day 1 TAVR cohorts using propensity-matched models.
Main Results:
- Same-day admission TAVR (Day 0) was associated with significantly lower hospitalization costs ($51,126 vs $57,703) and shorter length of stay (5.87 days vs 7.20 days) compared to Day 1 TAVR.
- In-hospital mortality and complication rates were similar between the two groups (31.5% vs 34.1%).
Conclusions:
- Elective endovascular TAVR performed on the same day of admission is associated with improved efficiency.
- Same-day admission TAVR leads to reduced costs and shorter hospital stays without compromising patient safety.
Background:
Since elective transcatheter aortic valve replacements (TAVRs) can be performed on the day of admission, i.e., Day 0, or on the next day of admission, i.e., Day 1, we sought to investigate if there is an advantage to either approach.
Methods:
We performed a retrospective cohort study, using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample database of 2012 and identified subjects undergoing endovascular (Transfemoral/Transaortic) TAVRs using the ICD-9-CM procedure code of 35.05. The cohort was divided based on the day of the TAVR performed, i.e., Day 0 or 1. The cost of the hospitalization and length of stay were the primary outcomes, with in-hospital mortality and procedural complications as the secondary outcomes. We identified a total of 843 TAVRs. Propensity matched models were created. The mean age of the study cohort was 82 years.
Results:
In a propensity-matched dataset, TAVRs performed on Day 0 were associated with a lower cost ($51,126 ± 1184 vs $57,703 ± 1508, p < 0.0001) and length of stay (mean days, standard error: 5.87 ± 0.25 vs 7.20 ± 0.29, p < 0.001) compared to Day 1. In-hospital mortality plus complication rates were relatively similar with no difference between Days 0 and 1 (31.5% vs 34.1%, p = 0.47, respectively).
Conclusions:
Endovascular TAVRs performed on the same day of admission are associated with lower hospitalization costs and length of stay, and similar mortality and complication rates compared to those performed on the next day of admission.
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