Next-day discharge after TAVR in an all-comer nonagenarian population

Given the aging of population in western countries, nonagenarians have been increasing. Subsequently, the number of nonagenarians affected by severe aortic stenosis and requiring transcatheter aortic valve replacement (TAVR) is expected to increase. Next-day discharge (NDD) after TAVR has been explored in several studies, demonstrating its feasibility and safety but no data in elder populations have been reported so far.

The aim of this study was to evaluate the safety of NDD following TAVR in nonagenarians. From November 2011 to May 2024, a total of 104 nonagenarian patients underwent transfemoral TAVR at our institution and 32 of them (31.7%) were discharged the day after the index procedure. NDD patients were compared to patients discharged later. The primary endpoints were device success and early safety according to Valve Academic Research Consortium-3 (VARC-3) criteria.

After propensity score matching, 29 well balanced pairs of patients were selected. At 30 days, NDD patients showed a higher early safety (93.1% vs. 69.0%; P = 0.04) and similar device success compared to those discharged later (89.7% vs. 100%; P = 0.48). No differences in all-cause death (3.4% vs. 17.2%; P = 0.20) and rehospitalization (13.8% vs. 13.8%; P = 1.00) were reported in NDD and no-NDD patients at 1 year.

In conclusion, NDD after TAVR has been shown to be a safe and effective strategy also in nonagenarian recipients, in which a shorter length of stay may help to avoid hospitalization-related complications.