Related Experiment Video
Updated: Nov 17, 2025
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Transcatheter aortic valve replacement same-day discharge for selected patients: a case series
Devesh Rai1, Muhammad Waqas Tahir1, Medhat Chowdhury1
1Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.
Insights
Same-day discharge (SDD) after transcatheter aortic valve replacement (TAVR) is feasible for select patients. This approach may reduce COVID-19 exposure risks for patients undergoing TAVR.
Area of Science:
- Cardiology
- Medical Technology
Background:
- The COVID-19 pandemic necessitated innovative healthcare strategies to minimize patient and staff infection risks.
- Transcatheter aortic valve replacement (TAVR) is a critical procedure for severe aortic stenosis.
- Developing protocols for reduced hospital stays is essential for healthcare system resilience.
Observation:
- A case series evaluated a protocol for same-day discharge (SDD) following transfemoral TAVR.
- Six patients with severe symptomatic aortic stenosis underwent TAVR and were discharged on the same day.
- Post-procedure monitoring included telemetry, ambulation, and real-time remote cardiac monitoring.
Findings:
- Successful transfemoral TAVR was performed on all six patients.
- Patients were discharged on the same day without new conduction abnormalities.
- Remote monitoring and tele-visits were utilized for follow-up care.
Implications:
- Same-day discharge (SDD) for selected TAVR patients appears feasible.
- This protocol can potentially reduce patient exposure to COVID-19 in healthcare settings.
- Remote cardiac monitoring facilitates safe early discharge after TAVR.
Background:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in drastic changes to the practice of medicine, requiring healthcare systems to find solutions to reduce the risk of infection. Using a case series, we propose a protocol for same-day discharge (SDD) for selected patients undergoing transcatheter aortic valve replacement (TAVR) using real-time remote cardiac monitoring. Six patients with severe symptomatic aortic stenosis underwent TAVR and were discharged on the same day.
Case Summary:
Six patients with symptomatic severe native or bioprosthetic aortic valve stenosis underwent a successful transfemoral TAVR using standard procedures, including the use of rapid atrial pacing to assess the need for permanent pacemaker implantation. Following TAVR, patients were monitored on telemetry in the recovery area for 3 h, ambulated to assess vascular access stability, and discharged with real-time remote cardiac monitoring if no new conduction abnormality was observed. The patients were seen by tele-visits within 2 days and 2 weeks after discharge.
Discussion:
Amidst the COVID-19 pandemic, SDD following successful transfemoral TAVR may be feasible for selected patients and reduce potential COVID-19 exposure.
