"Simple" Transcatheter Aortic Valve Replacement With Conscious Sedation: Safety and Effectiveness in Real-World...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter aortic valve replacement (TAVR) is a standard treatment for aortic stenosis.
• Current TAVR protocols often involve strict patient selection and intensive post-procedural care, potentially limiting accessibility and increasing costs.
• Shortening hospital stays after TAVR is desirable for improving patient flow and reducing healthcare expenses.

Purpose of the Study:

• To evaluate the safety and effectiveness of a simplified TAVR protocol.
• To assess the feasibility of early hospital discharge following a less rigorous patient selection and perioperative care pathway.
• To determine if a

Main Methods:

• Retrospective review of 524 TAVR procedures performed between March 2015 and February 2020.
• Identification of 344 procedures (65.6%) qualifying as "simple TAVR" based on less rigorous patient selection and conscious sedation.
• Analysis of procedural success, 30-day complication rates, and length of hospital stay.

Main Results:

• All 344 "simple TAVR" procedures were successful.
• Low rates of major complications: <3% for major vascular complications, stroke, and all-cause mortality.
• High rates of early discharge: 73.3% discharged on post-TAVR day 1, and 89.2% within 48 hours.

Conclusions:

• "Simple TAVR" is a safe, economical, and feasible approach in real-world practice.
• This simplified protocol does not require stringent perioperative protocols or patient selection.
• Early hospital discharge is achievable with this streamlined TAVR approach.