Cardiovascular procedures in ambulatory cardiac procedures: really?

Area of Science:

• Cardiology
• Ambulatory Surgery
• Health Services Research

Background:

• Same-day discharge (SDD) is increasingly explored for ambulatory cardiac procedures.
• Percutaneous coronary interventions (PCI) are a key focus for SDD feasibility.
• Technological advancements and enhanced recovery pathways are shaping SDD protocols.

Purpose of the Study:

• To evaluate trends, safety, and feasibility of SDD in ambulatory cardiac procedures, especially PCI.
• To assess the impact of technology on SDD.
• To explore future directions for expanding SDD to complex cardiac procedures.

Main Methods:

• Review of recent studies on SDD in ambulatory cardiac procedures.
• Analysis of technological advancements influencing SDD.
• Evaluation of Enhanced Recovery After Surgery (ERAS) pathways in ambulatory settings.

Main Results:

• SDD after PCI is well-tolerated and effective for selected patients, with outcomes comparable to overnight hospitalization.
• Advancements like improved stent designs, smaller sheaths, and transradial approach boost SDD feasibility.
• ERAS pathways improve safety, but challenges in eligibility determination persist, especially in resource-limited settings.

Conclusions:

• SDD is a viable, cost-effective option for low-risk patients undergoing PCI and other ambulatory cardiac procedures.
• Successful SDD hinges on careful patient selection, standardized protocols, and vigilant monitoring.
• Future research should refine selection tools, expand SDD to complex cases, and leverage technology for post-discharge monitoring.