Outcomes of Telemedicine TAVR Preoperative Evaluations

Telemedicine has seen widespread adoption in cardiovascular care following the COVID-19 pandemic. However, it remains unclear whether preoperative telemedicine evaluations (TMEs) for patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) produce outcomes comparable to in-person evaluations (IPE).

The purpose of this study was to evaluate whether TME, compared to IPE, is associated with differences in clinical outcomes following TAVR.

This retrospective study included consecutive adult patients who underwent TAVR at a single academic center from January 2021 to December 2022. Patients were evaluated either via TME or IPE in the outpatient setting. The primary outcome was a 30-day composite of mortality, stroke, vascular complications, and readmission. Secondary outcomes included the individual components of the primary outcome, total direct cost, hospital length of stay, and time from evaluation to procedure.

Among 497 patients, 361 (73%) underwent TME. Baseline characteristics, comorbidities, and Society of Thoracic Surgeons scores (3.5% vs 3.3%; P = 0.46) were similar between groups. There were no significant differences in the 30-day composite outcome in the TME vs the IPE group (17.5% vs 14.7%; P = 0.41), mortality (1.4% vs 0.74%; P = 0.55), readmissions (15.2% vs 13.2%; P = 0.57), stroke (1.4% vs 1.5%; P = 0.94), or vascular complications. Median direct costs, hospital length of stay (LOS), and wait times were also comparable.

Preoperative TME is associated with similar clinical outcomes compared to IPE. These findings support further exploration of telemedicine as a tool to expand access and maintain quality in structural heart care.